Abstract
Background
To date, chronic toxic encephalopathy (CTE) has never been described in operating room personnel.
Case report
We report two cases of anaesthetists who developed this pathology. They have both used anaesthetic gases for many years in paediatric surgery. Air conditioning was deficient during three years in operating rooms and atmospheric anaesthetics concentration was high (N2O mean concentration: 311 ppm, peak levels 1,600 ppm; halogenated: 16 ppm, peak levels: 1,600 ppm).
Clinical symptoms
Mood troubles and non-specific neuropsychic deficits gradually evolved until they had to stop working. Neuropsychological assessment showed important deficits in attention, executive functioning, short-term memory and visuo-spatial organization. Blood tests, VEPs, MRI, neuroSPECT and cardiovascular exams were normal. Troubles had slowly improved after cessation of exposure and sequels still remain.
Conclusion
These CTE cases seem to be the consequence of a long-term exposure to important levels of anaesthetic gases, and particularly nitrous oxide. It points out the importance of preventive measures in operating rooms, where occupational hazards are varied.
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Acknowledgments
The authors wish to thank the two patients and their specialists, orthophonists, neuropsychologists, neurologists and psychiatrists for the time spent to collaborate, in various ways, to this project; the occupational practitioner and technical staff of this hospital who have helped us. We are also grateful to Laura Safa for translation help.
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Dreyfus, E., Tramoni, E. & Lehucher-Michel, MP. Persistent cognitive functioning deficits in operating rooms: two cases. Int Arch Occup Environ Health 82, 125–130 (2008). https://doi.org/10.1007/s00420-008-0302-8
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DOI: https://doi.org/10.1007/s00420-008-0302-8