Department of Surgery, University of Colorado School of Medicine, Aurora, CO, USA.
Ann Surg. 2012 Aug;256(2):213-8. doi: 10.1097/SLA.0b013e318260263e.
(1) To determine if antenna coupling occurs in common operating room scenarios. (2) To define modifiable clinical variables that reduce the magnitude of antenna coupling.
Mechanisms of electrosurgical burns where monitoring devices contact the surgical patient are unclear. Antenna coupling occurs when the "bovie" active electrode (electrically active transmitting antenna) emits energy, which is captured by a nonelectrically active wire (electrically inactive receiving antenna) in close proximity without direct contact.
Monopolar radiofrequency energy was delivered to a laparoscopic instrument (electrically active transmitting antenna), whereas other nonelectrically active wires (electrically inactive receiving antenna) including electrocardiogram (EKG) lead, nonactive "bovie" pencil, and nerve electrode monitor were placed in proximity. Temperature changes of tissue placed adjacent to the electrically inactive receiving antennae were measured.
Nonelectrically active wires (receiving antenna) increase tissue temperature when lying parallel to the active electrode cord: EKG pad 2.4°C ± 1.2°C (P = 0.002), "bovie" pencil tip 90°C ± 9°C (P < 0.001), and nerve electrode monitor 106°C ± 12°C (P < 0.001). Factors that reduced the heat generated by antenna coupling included the following: increasing angulation between transmitting and receiving antennae (parallel = 90°C ± 9°C; 45° angle = 53°C ± 10°C; perpendicular = 35°C ± 11°C; P < .001), increasing separation distance between parallel transmitting and receiving antenna (<1 cm = 90°C ± 9°C; 15 cm = 44°C ± 18°C; 30 cm = 39°C ± 2°C; P < .001); and decreasing generator power setting (15 W = 59°C ± 11°C; 30 W = 90°C ± 9°C; 45 W = 98°C ± 8°C; P < .001).
Antenna coupling occurs in common operating room scenarios. Simple, practical measures by the surgeon, such as orienting the receiving antenna at a greater angle and with greater separation to the active electrode cord, or lowering the generator power setting reduce antenna coupling.
（1）确定在常见手术室场景中是否发生天线耦合。（2）确定可修改的临床变量，以降低天线耦合的幅度。
监测设备接触手术患者时发生电外科灼伤的机制尚不清楚。当“bovie”（一种高频手术器）的有源电极（发射天线）发射能量时，会发生天线耦合，能量被附近的无源电线（接收天线）捕获，即使没有直接接触。
单极射频能量被传递到腹腔镜器械（发射天线），而其他无源电线（接收天线），包括心电图（EKG）导联、非活动“bovie”铅笔和神经电极监测器，被放置在附近。测量放置在无源接收天线附近的组织的温度变化。
当无源电线（接收天线）与有源电极线平行放置时，组织温度会升高：EKG 垫 2.4°C ± 1.2°C（P = 0.002），“bovie”铅笔尖端 90°C ± 9°C（P < 0.001），神经电极监测器 106°C ± 12°C（P < 0.001）。减少天线耦合产生的热量的因素包括以下几点：增加发射天线和接收天线之间的角度（平行= 90°C ± 9°C；45°角= 53°C ± 10°C；垂直= 35°C ± 11°C；P <.001），增加平行发射天线和接收天线之间的距离（<1 cm = 90°C ± 9°C；15 cm = 44°C ± 18°C；30 cm = 39°C ± 2°C；P <.001）；以及降低发生器功率设置（15 W = 59°C ± 11°C；30 W = 90°C ± 9°C；45 W = 98°C ± 8°C；P <.001）。
天线耦合发生在常见手术室场景中。外科医生采取简单实用的措施，例如将接收天线以更大的角度和更大的距离定向到有源电极线，或降低发生器功率设置，可减少天线耦合。
