Observational study of radiation exposure in anesthetic personnel during spinal surgery

Background: Scatter radiation while using fluoroscopy to localize and aid during spinal surgery, reflected from the patient toward everyone in the operating room. Additionally, in neuro-interventional angiographic procedures, radiation exposure in anesthetic personnel is more than other participating medical personnel. Objective: To measure the radiation exposures in the anesthetic personnel and working environment during fluoroscopic- guided spinal surgery. Materials and Methods: The present study was a prospective observational study approved by the IRB and performed among 66 fluoroscopic-guided spinal surgeries. All participating anesthetic personnel were tagged with optical stimulated luminescent dosimeters at the collar level and at upper chest underneath the apron. By using working manner and positions with respect to the patient, they were categorized in three groups, S group, which were the nurse anesthetists, PS group, which were the residents and trainee nurse anesthetists, and SNP group, which were the anesthesiologists. For the PS group only, a third dosimeter was tagged at the level of the eye. Fluoroscopy time (minutes), radiation dose (^Gy-cm2), frequency, and duration of the drug administration were recorded throughout the operation. Regarding the working environment, the radiation exposures at the left and right side of the walls and the anesthetic machines were also measured. The dosimeters were sent to the Thailand Institute of Nuclear Technology to measure the radiation exposure every month for five consecutive months. Results: Sixty-six fluoroscopic-guided spinal operations were performed, and the radiation doses were measured in 50 anesthetic personnel. There was no statistical difference in radiation exposure among the groups regarding the one-month averaged radiation exposure (S 0.016±0.012 mSv, PS 0.017±0.013 mSv, and SNP 0.018±0.013 mSv, p=0.929). There was no statistical difference in radiation exposure between the anesthetic machine and the left wall (p=0.567) and the right wall (p=0.509). There was no correlation between the radiation exposure and frequency (p=0.625) and duration of the drug administration (p=0.314). Conclusion: The calculated annual radiation exposure in the anesthetic personnel during fluoroscopic-guided spinal surgeries is lower than the recommended dose limit of 20 mSv/year.