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Anesth Analg 2001;92:384-388
© 2001 International Anesthesia Research Society

TECHNOLOGY, COMPUTING, AND SIMULATION

Radiofrequency Transmission to Monitoring Devices in the Operating Room: A Simulation Study

Stephen E. McNulty, DO, Benjamin Kline, MD, Joseph Welsh, DO, and Richard Bartkowski, MD, PhD

Department of Anesthesiology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania

Address correspondence and reprint requests to Stephen E. McNulty, DO, Thomas Jefferson University Hospital, Department of Anesthesiology, 111 South 11th Street, Suite G-8490, Philadelphia, PA 19107-5092.

We evaluated radiofrequency (RF) transmission to various monitoring devices using circuits that simulated potentially hazardous conditions for patients in the operating room. Right heart ejection fraction (REF) pulmonary artery catheters, transesophageal atrial pacing stethoscopes, and temperature-sensing esophageal stethoscopes were subjected to RF transmission from an electrosurgery unit. Peak voltage and spark intensity were measured in circuits between the electrocautery dispersive pad and conductive elements of the various medical devices. All monitoring devices with an exposed conductive surface were found to have induced voltages and even spark generation. The ranking for peak voltage from least to most was as follows: disrupted esophageal stethoscope (620 volts), the transesophageal pacemaker (640 volts), and the REF pulmonary artery catheter (PAC) (680 volts). Peak voltage measurements of the REF PAC significantly decreased from 388 ± 23 to 142 ± 22 volts (P < 0.0001, Student’s t-tests) in a fluid medium compared to air. In a fluid medium, peak voltage significantly decreased from 142 ± 22 to 85 ± 15 volts (P < 0.0001, Student’s t-tests) when the REF PAC was connected to the cardiopulmonary monitor.

Implications: Circuit simulations were used to evaluate radiofrequency transmission from the electrosurgical unit (ESU) to monitoring devices in the operating room. A connection between the dispersive electrode and a medical device can occur outside the body, as simulated by current passing through an electrolyte fluid medium; or through higher resistance pathways such as body tissue, as simulated by current passing through water. The variability in voltage and spark intensity among the monitoring devices that we investigated suggests different relative risks for an ESU-induced thermal injury.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2001 by the International Anesthesia Research Society.