Radiation exposure to anaesthetists during interventional radiology*

Abstract

SummaryThis prospective study determined the level of radiation exposure of anaesthetists during interventional radiological procedures performed in the endoscopic retrograde cholangiopancreatography suite and cardiac catheterisation laboratory and compared it with the current safety guidelines. Anaesthetists wore area-specific lithium fluoride thermo-luminescent dosimeter badges at standardised positions. A total of 1344 procedures were performed over a 6-month period. Anaesthetists were involved in 39 ⁄ 645 (6.0%) procedures associated with ionisation radiation in the endoscopic retrograde cholangiopancreatography suite and 86 ⁄ 699 (12.3%) in the cardiac catheterisation laboratory. The mean (SD) duration of endoscopic retrograde cholangiopancreatography was 54.8 (29.1) min compared with 67.9 (42.8) min for cardiac catheterisation suite procedures (p = 0.058). The mean (SD) fluoroscopy time per procedure for endoscopic retrograde cholangiopancreatography was 5.5 (4.1) min compared with 12 (10.9) min in the cardiac catheterisation suite (p < 0.001). The combined net radiation exposure over 6 months was 0.28 mSv for endoscopic retrograde cholangiopancreatography procedures and 2.32 mSv in the cardiac catheterisation suite. The combined exposure was less than the maximum recommended exposure of 20 mSv per year.

Assessing the level of radiation experienced by anesthesiologists during transfemoral Transcatheter Aortic Valve Implantation and protection by a lead cap

“…As a consequence, working in radiation environment like the CathLab will become more and more for anesthesiologists. Although radiation dosage has decreased by implementation of new technologies [30] and procedural experience [31] worldwide, the anesthesiologist’s exposure to radiation is generally considered to be higher in TAVI than in other interventional procedures [12, 32]. Newer protection systems for interventional cardiologists [12] are not suitable for anesthesiologists as they are designed for a static position and not for variable working positions.…”

The radiation environment of anaesthesiologists in the endoscopic retrograde cholangiopancreatography room

“…When airway manipulation was required, the distance was reduced to between 40 and 60 cm. Thermoluminescent dosimeters (UD-802, Panasonic Communications Kyushu Co., Ltd., Ueda Usa, Oita, Japan) were used to measure the cumulative radiation exposure of the anaesthesiologists at the neck outside the thyroid shield and the dominant wrist 4 . These thermoluminescent badges use the tissue equivalent (Li 2 B 4 O 7 :Cu) and are highly sensitive (CaSO 4 :Tm), making it possible to precisely measure various types of radiation over a wide range of doses (10 μSv–10 Sv).…”

“…Among these procedures involving NORA, there is a growing number of radiation-assisted procedures, especially those performed in the endoscopic retrograde cholangiopancreatography (ERCP) room 2,3 . A previous study reported that the radiation environment differed according to the NORA setting; it was higher for the cardiac catheterisation laboratory than for interventional radiology and higher for monitored sedation than for the general anaesthesia setting 4 .…”

2018 ACC/HRS/NASCI/SCAI/SCCT Expert Consensus Document on Optimal Use of Ionizing Radiation in Cardiovascular Imaging: Best Practices for Safety and Effectiveness—A Review for the Cardiac Anesthesiologist

“…23,24 This may not be optimal always for the operator and the anesthesiologist. 25 It is therefore important for the cardiac anesthesiologist to focus on dose-reduction strategies that emphasize the use and maintenance of personal radiation-protective equipment.…”