Persistent cognitive functioning deficits in operating rooms: two cases.
BACKGROUND
To date, chronic toxic encephalopathy (CTE) has never been described in operating room personnel.


METHODS
We report two cases of anaesthetists who developed this pathology. They have both used anaesthetic gases for many years in paediatric surgery. Air conditioning was deficient during three years in operating rooms and atmospheric anaesthetics concentration was high (N(2)O mean concentration: 311 ppm, peak levels 1,600 ppm; halogenated: 16 ppm, peak levels: 1,600 ppm).


METHODS
Mood troubles and non-specific neuropsychic deficits gradually evolved until they had to stop working. Neuropsychological assessment showed important deficits in attention, executive functioning, short-term memory and visuo-spatial organization. Blood tests, VEPs, MRI, neuroSPECT and cardiovascular exams were normal. Troubles had slowly improved after cessation of exposure and sequels still remain.


CONCLUSIONS
These CTE cases seem to be the consequence of a long-term exposure to important levels of anaesthetic gases, and particularly nitrous oxide. It points out the importance of preventive measures in operating rooms, where occupational hazards are varied.
Dreyfus
Elsa
E
Consultation de Pathologie Professionnelle, AP-HM Timone, Marseille, France.
Tramoni
Eve
E
Lehucher-Michel
Marie-Pascale
MP
D000776:Anesthesiology; D018685:Anesthetics, Inhalation / Q000009:adverse effects* / Q000032:analysis; D003072:Cognition Disorders / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D020258:Neurotoxicity Syndromes / Q000175:diagnosis / Q000628:therapy; D009609:Nitrous Oxide / Q000009:adverse effects* / Q000032:analysis; D009784:Occupational Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D016273:Occupational Exposure / Q000009:adverse effects* / Q000032:analysis; D009873:Operating Rooms; D010564:Personnel, Hospital; D016896:Treatment Outcome; D014691:Ventilation
D018685:Anesthetics, Inhalation; D009609:Nitrous Oxide