Effects of vacuum suctioning and strategic drape tenting on oxygen concentration in a simulated surgical field.

Study Objective: To investigate the isolated and combined effects of vacuum suctioning and strategic drape tenting on oxygen concentration in an experimental setting.

Design: Experimental.

Setting: Clinical simulation center of a university-affiliated hospital.

Participants: Mannequin simulation of a patient undergoing facial surgery under sedation anesthesia. Supplemental oxygen was delivered via nasal cannula.

Interventions: Vacuum suctioning and strategic drape tenting.

Measurements: The experimental trials entailed measuring oxygen concentration around the nasal cannula continuously either in the presence or absence of a standard operating room vacuum suction system and strategic tenting of surgical drapes. The primary outcome was the time required for oxygen concentration to reach 21%.

Main Results: In the control group (without suction or strategic tenting), a mean time of 180 seconds elapsed until the measured oxygen concentration reached 21% after cessation of oxygen delivery. Use of a vacuum suction device alone (110 seconds; P < .01) or in combination with strategic tenting (110 seconds; P < .01) significantly reduced this time. No significant benefit was seen when tenting was used alone (160 seconds; P < .30).

Conclusion: Use of a vacuum suction device during surgery will lower local oxygen concentration, and this in turn may decrease the risk of operating room fires. Although strategic tenting of surgical drapes has a theoretical benefit to decreasing the pooling of oxygen around the surgical site, further investigation is necessary before its routine use is recommended.