Nurse Anesthesia Program, Oregon Health and Science University, SON #521, 3455 SW US Veterans Hospital Rd, Portland, OR, 97239, USA.
J Anesth. 2020 Aug;34(4):575-584. doi: 10.1007/s00540-020-02775-x. Epub 2020 Apr 15.
Surgical smoke generated by use of electrosurgical units (ESUs), lasers, and ultrasonic scalpels constitutes a physical, chemical, and biological hazard for anesthesia personnel. Inhalation of particulate matter with inflammatory consequences, pulmonary injury from products of tissue pyrolysis, exposure to mutagens and carcinogens, and the transmission of human papillomavirus (HPV) and possibly other pathogens represent a spectrum of adverse effects associated with the occupational exposure to surgical plume. While adequate operating room ventilation and use of high filtration-efficiency masks offer some protection from these conditions, the most effective method of safeguarding against surgical smoke involves its removal with a dedicated smoke evacuation device (SED). Despite the fact that many professional and governmental agencies have endorsed widespread usage of SEDs, anesthesia providers have been largely silent on this subject, with few reports within the field of anesthesiology and perioperative medicine regarding these hazards. SED use is relatively infrequent in most surgeries, and this condition reflects surgeons' reluctance to employ these devices, likely resulting from lack of education and less than optimal technology. Anesthesia societies and academic centers can serve critical roles in advocating employment of SEDs in much the same way that they have supported perioperative smoking cessation.
使用电外科设备（ESU）、激光和超声手术刀产生的手术烟雾对麻醉人员构成物理、化学和生物危害。吸入具有炎症后果的颗粒物、组织热解产物引起的肺损伤、暴露于诱变剂和致癌物质以及人乳头瘤病毒（HPV）和可能其他病原体的传播代表了与职业暴露于手术烟雾相关的一系列不良影响。虽然充分的手术室通风和使用高效过滤口罩可以提供一些保护，但防止手术烟雾的最有效方法是使用专用的烟雾排空设备（SED）将其清除。尽管许多专业和政府机构都认可广泛使用 SED，但麻醉提供者在这个问题上基本保持沉默，在麻醉学和围手术期医学领域很少有关于这些危害的报道。SED 在大多数手术中的使用频率相对较低，这种情况反映了外科医生不愿意使用这些设备，可能是由于缺乏教育和技术不够理想。麻醉学会和学术中心可以在提倡使用 SED 方面发挥关键作用，就像他们支持围手术期戒烟一样。
