Published Nov 7, 2003
icurn96
15 Posts
Greetings! I'm a first semester CRNA student with almost 3 months of didactic behind me (767 days left until graduation) Like lots of women, I have made the tough decision to postpone having children until completing this program. I've been married 5 years and have a wonderfully patient husband beyond belief. I was recently informed of (or alarmed by) the implications of anesthesia & waste gases on childbearing, specifically the increased risk of spontaneous abortion and birth defects. Am I being silly by worrying about this? This is the LAST thing my husband and I need to hear regarding this career choice that I am so eagerly anticipating. Hopefully some of you in the field who are much more well-versed than I can reply and tell me that I'm being paranoid. I mean, part of me wants to believe that technology and developments have taken measures to decrease the risks (better biomed checks and balances, better OR ventilation, better anesthesia delivery techniques, etc.) But I can't help but be concerned. Are some agents worse than others? Or is it related to certain trimester exposure? I realize I need to do some research and delve into the fact-finding/statistics, but as you might imagine....not much free time these days for extraneous tasks. Any comments or thoughts?
yoga crna
530 Posts
This subject has been very well studied and I would suggest that you do a Medline search on the topic. As an anesthesia student, you should know how to do that.
If I remember correctly, stress was considered a more important factor than breathing in trace vapors of anesthetics. I believe there is just as high spontaneous abortion rate among ICU nurses as anesthesia professionals.
My personal opinion is that it doesn't make any difference. There have been many bright people whose parents have been nurse anesthetists, including President Bill Clinton, Govenor Jesse Ventura, one of the founders of eBay, Rick Rock and many just plain regular people.
Let us know what you find out from your Medline search.
YogaCRNA
Thanks for your feedback, YogaCRNA. Yes, I'm all too familiar with Medline from my undergrad days. I will definitely do some searching there as soon as I can emerge from all these books and tests in the next few weeks. I was just hoping for some general knowledge here in the mean time. I suppose you could say I have respect and appreciation for words of wisdom and experience!
loisane
415 Posts
I do believe that modern scavenging, and newer agents have made a favorable impact on this issue.
Even so, in the settings I have worked we have taken a few common sense precautions. Pregnant women, or those trying to get pregnant, would not do kids, so as to be able to avoid mask inductions. Get someone else to fill their vaporizers, etc. Don't know if it is really necessary, but it couldn't hurt.
But botton line, female CRNAs have successful pregnancies all the time. So that would seem to tell the tale.
loisane crna
Thank you so much. That is exactly the type of feedback I was hoping to find from CRNA's in the day-to-day clinical setting. I was just hoping to hear either from women who had started their family while working or maybe from those with colleagues who had healthy babies & successful pregnancies. To tell you the truth, our focus right now is just getting me through school with grades to be proud of. The notion of having children is just so on the back burner....I mean the LEAST of my worries right now. But when someone mentioned a scary possibility like birth defects/spontaneous abortions, I felt compelled to pick ya'lls brains. Again, I appreciate the positive words.
ivypetals
40 Posts
I am interested in this topic...could you please share with me what you found. You can send me a private email.[/email]
Kind regards,
jewelcutt
268 Posts
I actually did a paper on this risk. The biggest breakthrough has been active scavenging systems, but there are still high risk times when gas exposure increases to anesthesia providers. These times include induction with poor mask seal, pediatric cases, and extubation with inhalation of exhaled gases. There have been studies that N2O makes conception more difficult, even for the wives of CRNAs, but the greatest risk is for the pregnant CRNA in the first trimester. Halogenated gases also pose a risk, but N2O has been deemed teratogenic and should be avoided if you are pregnant and providing. Methylmethacrylate rooms should be avoided, along with procedures requiring radiology because flouro has the most exposure. Physical stress, long shifts, and multiple short cases also stress the pregnant body. I have noticed that anesthesia departments have mini policies of which procedures to avoid placing CRNAs. You always have the discretion of refusing cases, this is usually not necessary because everyone is very understanding and helps the pregnant providers. You just have to learn how to not use N2O on a wakeup! There are soooooo many pregnant CRNAs that I'm beginning to think something is in the water, so I am competely avoiding the hospital water supply! You just have to be vigilant about your exposure, always turn off the gas before taking the mask off of the patient for whatever reason. If you want more thorough info, check out the OSHA guidelines at http://www.medgasexperts.com, It shouldn't be too hard to find in the website.
kabarnes
28 Posts
Hi just curious, but wouldn't anyone in the OR be exposed to small amounts of gas too (the surgeon, nurses and techs). Maybe not as much since they are usually not right next to the patient's head. I was just wondering, if anyone has any comments.