Scavenger of Waste Anesthetic

Waste anesthetic gases (WAGs) are associated with spontaneous miscarriages in pregnant persons, an increased risk of congenital abnormalities, hepatotoxicity, neurotoxicity, and cognitive impairment. Through monitoring anesthesiologists we found levels of WAGs to be 5-10x the current standard inside the OR. Currently, no solutions exist for the mitigation of WAG release. Remora is a solution to removing WAGs that fits on top of existing anesthesia masks. A flexible skirt is joined to a rigid ring, which deforms under hand pressure to facilitate effective hand-to-mask placement. The suction system is plugged into an unused suction port to create an area under the anesthesia mask that is depressurized, creating circumferential suction around the mask. The negative pressure gradient between the Remora-mask unit and room air pulls WAGs into the gap between the anesthesia mask and Remora, and then into the anesthesia machine\u27s suction system. From there, WAGs are exhausted into the air handling system which receives other waste gases. Using visible gas we were able to show how much WAGs may be escaping during induction and the amount Remora was able to scavenge. While we were unable to quantify our results, we were able to qualitatively show that the amount of gas was significantly less once Remora was turned on. Our hope is to perform further studies to prove that with the use of Remora the concentration of WAGs will decrease in the OR and decrease the negative side effects associated with WAGs

Device for the Capture and Extraction of Waste Anesthetic Gas

Background: Leaks occur often throughout the process of delivering inhaled anesthesia prior to and during surgery. Leaks typically occur around the patient’s mouth, nose, and eyes. Potent inhaled anesthetics (PIAs) include halothane, sevoflurane, desflurane, and isoflurane. All PIAs, to one degree or another, pose hazards to human health. PIAs are associated with reproductive toxicity, spontaneous miscarriages in pregnant persons as well as an increased risk of congenital abnormalities in offspring. In other words, PIAs are thought to be both abortifacients as well as teratogens. PIAs are also associated with hepatotoxicity, neurotoxicity, cognitive impairment, as well as increased incidence of malignancy. Methods: Preliminary interviews with stakeholders were conducted to assess the desirability, viability, and utility of a product to trap and remove waste anesthetic gas (WAG) from the perifacial region before it diffuses into the ambient air. We used wearable detector badges (similar to a dosimeter) from Assay Technology Inc. for qualitative measurements of WAG levels in several operating rooms. We used low-fidelity mockups for early prototyping, FDM and SLA 3D printing techniques, and urethane casts for high-fidelity working prototypes. We also performed real-time simulations using a visible aerosol agent in order to record and study the efficacy of our device. Results: We found dramatically elevated levels of sevoflurane in the operating room, with our highest readings at ~10x NIOSH permissible exposure limits. With our visual simulation we saw a markedly reduced flow of WAG into the surrounding air. Conclusions: Our device adequately addresses a significant and unaddressed issue in healthcare and shows viability from an economic standpoint as well. We are currently designing a study to further evaluate levels of WAG and exploring potential studies with live anesthetic agents

Anesthesia for the patient with a recently diagnosed concussion: think about the brain!

Some patients require emergent, urgent, or elective surgery in the time period immediately following diagnosis of concussion. However, changes in brain homeostatic mechanisms following a concussion and concern for secondary brain injury can complicate the decision as to whether or not a surgery should proceed or be postponed. Given the paucity of available evidence, further evaluation of the use of anesthesia in a patient with concussion is warranted. This article summarizes what is currently known about the relevant pathophysiology of concussion, intraoperative anesthesia considerations, and effects of anesthesia on concussion outcomes in an attempt to help providers understand the risks that may accompany surgery and anesthesia in this patient population. While most contraindications to the use of anesthesia in concussed patients are relative, there are nonetheless pathophysiologic changes associated with a concussion that can increase risk of its use. Understanding these changes and anesthetic implications can help providers optimize outcomes in this patient population

High dose vitamin D supplementation can improve menstrual problems, dysmenorrhea and premenstrual syndrome in adolescents

Vitamin D has a crucial role in female reproduction, possibly through its effects on calcium homeostasis, cyclic sex steroid hormone fluctuations, or neurotransmitter function. We have assessed the effects of vitamin D supplementation on dysmenorrhea and premenstrual syndrome (PMS) in adolescents. In this study, 897 adolescent girls living in Mashhad and Sabzevar, Iran, received 9 high-dose vitamin D supplements (as 50000 IU/ week of cholecalciferol) and were followed up over 9 weeks. We evaluated the effect of vitamin D supplementation on individuals in 4 categories: those with only PMS; individuals with only dysmenorrhea; subjects with both PMS and dysmenorrhea and normal subjects. The prevalence of PMS after the intervention fell from 14.9% to 4.8% (P<0.001). Similar results were also found for the prevalence of subjects with dysmenorrhea (35.9% reduced to 32.4%), and in subjects with both PMS and dysmenorrhea (32.7% reduced 25.7%). Vitamin D supplementation was associated with a reduction in the incidence of several symptoms of PMS such as backache and tendency to cry easily as well decrement in pain severity of dysmenorrhea (P<0.05). High dose vitamin D supplementation can reduced the prevalence of PMS and dysmenorrhea as well has positive effects on the physical and psychological symptoms of PMS