A Study on Effects of Leaking Carbon Dioxide Gas on Surgeons during Laparoscopic Surgeries

Background: Laparoscopic surgery is gold standard for treating various abdominal diseases. Carbon dioxide, having high safety profile, is the most commonly used gas for insufflating peritoneal cavity for accurate visualization and operative manipulation. Despite the fact that CO 2 is naturally present in the atmosphere, i.e., 0.035% (350 ppm), it is one of the most overlooked toxic gases. CO 2 breathing causes numerous cardiorespiratory responses and psychological reactions, such as impaired vision, diminished motor control, slowed responses, disorientation, or reduced attentional capacities that may jeopardize a worker's health and safety. At high concentrations (8%), it has been shown to cause unconsciousness almost instantaneously and respiratory arrest within 1 minute. As laparoscopic surgeons are under constant exposure of leaking CO 2 gas, this study is taken up to evaluate the effects of CO 2 on them by a noninvasive technique that measures end-tidal CO 2 of operating surgeons at the beginning and end of laparoscopic surgeries. Objective: To evaluate the effects of leaking CO 2 gas on surgeons during laparoscopic surgeries. Methods: A Mini-Mental State Exam (MMSE) score and EtCO 2 levels (using a capnometer with 4 L of oxygen/minute) of operating surgeons were obtained before the start of surgery. After surgery, MMSE scores and EtCO 2 levels were again documented, compared, and analyzed using SPSS software. Results: The mean EtCO 2 before surgery was found to be 30.86 with standard deviation of 4.03 and that after surgery was 31.23 with standard deviation of 3.85 with mean duration of surgery being 73 minutes. Correlation of individual EtCO 2 values before and after surgery did not show significant changes (p value = 0.534). The difference in MMSE scale scores before and after surgery for all participated surgeons was insignificant.