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.