The Operating Room

Emory University Schooi of Medicine Atianta, Georgia 

Marcel Dekker, Inc. 270 Madison Avenue, New Yoifc, New York 10016 

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The agent should be odorless, nonflammable at concentrations which are likely to be used in the operating room, and stable both on storage and to soda lime, which is used as the CO2 absorber in the anesthetic circuit. Induction of, and recovery from, anesthesia should be rapid, and minimal side effects... 

At high pressure experiments the reactor should be installed in a pressure cell. All check valves before it, and the filter with the flow controller after it, can be kept in the vented operating room. As a minimum, the bypass valve and the flow controller must be accessible to the operator. This can be done by extended valve stems that reach through the protecting wall. Both the operating room and the pressure cell should be well ventilated and equipped by CO alarm instruments. 

There has been some controversy over the effect of traces of anesthehc gases in the operating room on the health of personnel working there daily Numerous animal studies usmg low levels of anestheltic gases have failed to show any effects, and several epidemiological studies show that human health is not affected by traces of anesthetic gases [20]... 

Malignant hyperthermia may occur outside the operating room. Gronert has described a patient who had episodic fever and a positive muscle biopsy for MH. MH may occur in the postoperative recovery room or even on return to the ward. 

Moneret-Vautrin DA Cross-reactions to muscle relaxants in the operating room. Clin Rev Allergy Immunol 1997 15 471. 

Give 100 mg of hydrocortisone sodium phosphate or hydrocortisone sodium succinate intramuscularly (provide "on call" to the operating room). 

Data reported by the NNIS from 1990 to 1996, adapted from National Academy of the Sciences National Research Council. Postoperative wound infections The influence of ultraviolet irradiation of the operating room and of various other factors. Ann Surg 1984 160 32-135. 

Although anesthesiologists tend to be associated with surgery, they also work outside the confines of the operating room. Research other locations where you might find an anesthesiologist. 

Epidemiological studies of occupationally exposed populations have examined possible carcinogenic and teratogenic effects of chronic exposure to the operating room environment. 

In clinical areas such as the operating room and neonatal and transplant units, shorter, less traumatic washing regimens may be used instead of lengthy scrub protocols with brushes or other harsh mechanical action. 

It goes upsilon where the operating room doesn t even exist Similarly, a 4-D creature s 3-D retina can see all of your insides without breaking your skin. This assumes that light rays are reflected into the fourth dimension—we ll have to research that further. I ve memorized Abbott s nice description of a 2-D creature lifted out of Flatland and looking down into his 2-D world from a 3-D world ... 

A source of ethylbenzene exposure to physicians and nurses in the operating room may be electrocautery smoke generated from dissection of tissues and cauterization of blood vessels (36 pg/m maximum detected in an area sample) (Sagar et al, 1996). Exposures to ethylbenzene from solvent use also occurred in a histology laboratory (Angerer Lehnert, 1979). 

A general view and a diagram of the operating room is given in Fig. 57 and 58 respectively. 

Although still used medically, at one time elher was ihe major anesthetic, for which it must be scrupulously pure In addition lo various side effects which may result from the use of ether as an anesthetic, it is a definite hazard in the operating room because of its explosive properties, particularly in enriched oxygen atmospheres. 

Frequently, a preoperative sedative is given to a patient 1 to 2 hours before the administration of general anesthesia.2,36 Sedatives are usually administered orally or by intramuscular injection, and are given while the patient is still in his or her room. This approach serves to relax the patient and reduce anxiety when arriving at the operating room. Commonly used preoperative sedatives include barbiturates (secobarbital, pentobarbital), opioids (butorphanol, meperidine), and benzodiazepines (diazepam, lorazepam) (Table 11-2). Different sedatives are selected depending on the patient, the type of general anesthesia used, and the preference of the physician. 

Efforts should be made to use these drugs sparingly, and to check that their effects have worn off before the patient leaves the operating room. In fact, electric stimulation of a peripheral nerve (e.g., ulnar nerve) can be used to objectively determine if there is residual muscle paralysis.1 The muscles supplied by the nerve must show an appropriate twitch response to a given electric stimulus to insure that the patient has recovered adequately from the neuromuscular blocking drug.20,31... 

Bugayev swept into the Operations Room with a nod at Tatyana, who glanced up meekly from her assigned terminal. He dug in his pocket for the photograph, but was interrupted by a trooper stationed in front of the... 

Meanwhile in America, laughing gas was appearing in traveling medicine shows and carnivals. Gardner Quincy Colton, a former medical student, presided over one of these nitrous oxide demonstrations in Hartford, Connecticut, in December of 1844. One of the audience volunteers who had just inhaled the gas injured his leg without feeling any pain. In the audience was dentist Horace Wells, who took note of this and immediately seized on the idea that nitrous oxide might be a powerful anesthetic in the operating room. 

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