Department of Anesthesiology, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA.
Anesthesiology. 2011 Mar;114(3):512-20. doi: 10.1097/ALN.0b013e31820c2b81.
Scatter radiation during interventional radiology procedures can produce cataracts in participating medical personnel. Standard safety equipment for the radiologist includes eye protection. The typical configuration of fluoroscopy equipment directs radiation scatter away from the radiologist and toward the anesthesiologist. This study analyzed facial radiation exposure of the anesthesiologist during interventional neuroradiology procedures.
Radiation exposure to the forehead of the anesthesiologist and radiologist was measured during 31 adult neuroradiologic procedures involving the head or neck. Variables hypothesized to affect anesthesiologist exposure were recorded for each procedure. These included total radiation emitted by fluoroscopic equipment, radiologist exposure, number of pharmacologic interventions performed by the anesthesiologist, and other variables.
Radiation exposure to the anesthesiologist's face averaged 6.5 ± 5.4 μSv per interventional procedure. This exposure was more than 6-fold greater (P < 0.0005) than for noninterventional angiographic procedures (1.0 ± 1.0) and averaged more than 3-fold the exposure of the radiologist (ratio, 3.2; 95% CI, 1.8-4.5). Multiple linear regression analysis showed that the exposure of the anesthesiologist was correlated with the number of pharmacologic interventions performed by the anesthesiologist and the total exposure of the radiologist.
Current guidelines for occupational radiation exposure to the eye are undergoing review and are likely to be lowered below the current 100-150 mSv/yr limit. Anesthesiologists who spend significant time in neurointerventional radiology suites may have ocular radiation exposure approaching that of a radiologist. To ensure parity with safety standards adopted by radiologists, these anesthesiologists should wear protective eyewear.
介入放射学过程中的散射辐射会导致参与医疗人员产生白内障。放射科医生的标准安全设备包括眼部防护。透视设备的典型配置将辐射散射从放射科医生引向麻醉师。本研究分析了介入神经放射学过程中麻醉师的面部辐射暴露情况。
在涉及头部或颈部的 31 例成人神经放射学程序中，测量了麻醉师和放射科医生的前额辐射暴露量。记录了每个程序中假设会影响麻醉师暴露的变量。这些变量包括透视设备发射的总辐射、放射科医生的暴露量、麻醉师进行的药物干预次数以及其他变量。
介入性程序中麻醉师面部的平均辐射暴露量为每次介入性程序 6.5 ± 5.4 μSv。这一暴露量比非介入性血管造影程序（1.0 ± 1.0）高出 6 倍以上（P < 0.0005），平均比放射科医生的暴露量高出 3 倍以上（比值为 3.2；95%CI，1.8-4.5）。多元线性回归分析表明，麻醉师的暴露量与麻醉师进行的药物干预次数和放射科医生的总暴露量有关。
目前针对眼部职业辐射暴露的指南正在进行审查，可能会降低到目前 100-150 mSv/yr 的限制以下。在神经介入放射学套房中花费大量时间的麻醉师可能会接近放射科医生的眼部辐射暴露量。为了确保与放射科医生采用的安全标准保持一致，这些麻醉师应佩戴防护眼镜。
