The radiation environment of anaesthesiologists in the endoscopic retrograde cholangiopancreatography room

Abstract

Anaesthesiologistsare increasingly involved in nonoperatingroomanaesthesia (NORA) for fluoroscopic procedures. However, theradiationexposure of medical staff differs among NORA settings. Therefore, we aimed to investigate theradiationenvironmentgenerated by fluoroscopicendoscopicretrogradecholangiopancreatography(ERCP) and theradiationexposure ofanaesthesiologists. The dose area product (DAP),radiationentrance dose (RED), and fluoroscopy time (FT) according to the procedures and monthly cumulativeradiationexposure were analysed at two sites (neck and wrist) from 363 procedures in 316 patients performed within 3 months. The total RED and DAP were 43643.1 mGy and 13681.1 Gycm2, respectively. DAP and RED (r = 0.924) were strongly correlated and DAP and FT (r = 0.701) and RED and FT (r = 0.749) were moderately correlated. Theradiationenvironmentper procedure varied widely, DAP and RED per FT were the highest during stent insertion with esophagogastroduodenoscopy. Monthly cumulative deep dose equivalents at the wrist and neck ranged between 0.31-1.27 mSv and 0.33-0.59 mSv, respectively, but they were related to jaw thrust manipulation (r = 0.997, P = 0.047) and not to theradiationenvironment. Theanaesthesiologistsmay be exposed to high dose ofradiationin the ERCProom, which depends on the volume of procedures performed and perhaps theanaesthesiologists' practice patterns.