Pregnancy and Propofol/sedation

[PinchandBurn]

Hi Guys-

it's been almost 4 years since I've done any anesthesia. I strictly do Pain Management now.

I just wanted to confirm with you guys, in the event something has changed.

If you are the anesthesiologist/surgeon doing a case and the patient is getting IV sedation (propofol, midaz, fent), is there any risk to the pregnant anesthesiologist/surgeon? My wife is a oral surgeon. She's in her first trimester. that's why I ask.

I thought I read 4 years ago, that propofol's breakdown can be measured in the exhalation vapor. That's why I ask.......I know it's a long shot, but I figured I should ask!

Thanks

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[deleted171991]

There shouldn't be any risk to the surgeon. Just think about all our female colleagues who practice anesthesia while pregnant. And propofol is not teratogenic. Plus how much of the IV anesthetic would end up in those vapors and being inhaled through the mask? ET propofol is in the range of less than 30 ppb (parts per billion).

I wouldn't swear that it's 101% safe, but I would be more concerned about x-rays.

 

[Noyac]

Ask Blade.

 

[PinchandBurn]

y?

 

[dhb]

If you are the anesthesiologist/surgeon doing a case and the patient is getting IV sedation (propofol, midaz, fent), is there any risk to the pregnant anesthesiologist/surgeon? My wife is a oral surgeon. She's in her first trimester. that's why I ask.

No

 

[BuzzPhreed]

Ask Blade.

y?

Because you can be assured to get a litany of papers on the subject carefully woven together all coming to whatever conclusion he wants you to believe.

 

[BuzzPhreed]

My wife is a oral surgeon. She's in her first trimester.

Let me guess: first child?

I'd worry more about the amalgams.

And xrays.

Oh, by the way... that kid is going to scrape his knees while playing and occasionally put dirty things in his mouth. I hope you have good health insurance and have already established a good professional relationship with the local emergency department.

 

[afteranesthesia]

You are fine. Slews of pregnant anesthesia residents and attendings have administered this over and over again throughout pregnancy. Not to mention inhaled volatile while inducing and intubating, worn lead for fluoro and pushed very heavy beds. For nine months.

 

[jwk]

Uphill - in the snow...

 

[24858]

Hi Guys-

it's been almost 4 years since I've done any anesthesia. I strictly do Pain Management now.

I just wanted to confirm with you guys, in the event something has changed.

If you are the anesthesiologist/surgeon doing a case and the patient is getting IV sedation (propofol, midaz, fent), is there any risk to the pregnant anesthesiologist/surgeon? My wife is a oral surgeon. She's in her first trimester. that's why I ask.

I thought I read 4 years ago, that propofol's breakdown can be measured in the exhalation vapor. That's why I ask.......I know it's a long shot, but I figured I should ask!

Thanks

I gave a grand rounds on this subject, more specifically, the effects of anesthetics on in vitro fertilization. my suggestion to you, would be to avoid the pedi rooms if you are a pregnant anesthesiologist. with mask inductions there is going to certainly be more immediate area contamination with gases. the literature shows, perhaps a correlational relationship between nitrous oxide exposure and miscarriage. however, all the data in regards to miscarriage and loss/promotion of in vitro fertilization is weak at best. from what i read, morphine may have an effect on embryo implantation, and there is a chance that ketorolac may be harmful. again, all the literature is weak, but then again, why take unnecessary risk?

 

[Noyac]

Hi Guys-

My wife is a oral surgeon.

Thanks

That's just wrong.

I wish my wife was an oral surgeon.😉

 

[pgg]

Were I pregnant, I'd avoid sniffing waste gases and rooms with more than a few seconds of fluoroscopy ... and then I'd cease worrying.

Actually, that's not a bad philosophy if you're not pregnant, too.

 

[Spinach Dip]

literature shows, perhaps a correlational relationship between nitrous oxide exposure and miscarriage.

N2O is an inhibitor of methionine synthase (it attacks the cobalt in the middle of the B12 cofactor required to regenerate he active form of the enzyme). Thus, it can be terratogenic in extreme cases. The younger the fetus, the greater the danger.

There is no evidence (AFAIK) that the other volatile agents have any similar action.

[/Biochemistry]



And I agree with the above, I'd be more scared of Xrays.

 

[deleted171991]

N2O is an inhibitor of methionine synthase (it attacks the cobalt in the middle of the B12 cofactor required to regenerate he active form of the enzyme). Thus, it can be terratogenic in extreme cases. The younger the fetus, the greater the danger.

There is no evidence (AFAIK) that the other volatile agents have any similar action.

[/Biochemistry].

Yeah, but they are using TIVA here. 😉

 

[Sublimazing]

is this real life?

 

[Arantius]

I had a misspent few years as an occupational health tech in a military hospital, and as I recall the most dangerous exposures were exposure to bone cement (especially when mixing), nitrous oxide, and (obviously) radiation/infectious agents. If the surgeons can use a fume suction device over the bone cement I recall that decreased the ppb of methylmethacrylate to safe levels. I think OSHA has a document for female surgeons if you look on their website or maybe ask an occupational med specialist? Good luck