A Simulation Study With Electronic Dosimeter to Estimate Patient and Personnel Dose in Orthopedic Surgery

The use of mini C-arm is required in many orthopedic surgeries as an image-guided tool. Studies have shown an unnecessarily high dose to patients if exposures are not properly optimized. Also, scatter radiation to personnel may increase the risk of cancer if an appropriate protective device is not used. 

This study aims to determine the patient’s dose and scatter radiation to the surgeon, anesthetist, and scrub nurse. Also, a comparison will be made with other studies on this topic. 

A phantom was designed to simulate a patient on the operating table to produce scatter radiation. In the same vein, a mobile mini C-arm unit was positioned with the x-ray tube beneath the head and the image receptor above the operating table. Measurements were made with a measuring tape from the central axis to the position of the surgeon, anesthetist, and scrub nurse. The Entrance Surface Dose (ESD) was determined by placing the electronic dosimeter at the surface of the phantom to estimate the patient dose. Similarly, each personnel dose/dose rate from the central axis was determined using a similar detector. 

The total average time for most orthopedic surgeries in the studied facility was 3.3 minutes. The estimated ESD to the patient was 25.03 µSv and the scatter radiation per patient reaching the simulated anesthetist, scrub nurse, and surgeon was, 3.75, 3.59, and 7.72 µSv, respectively. The estimated dose values per year to anesthetist, scrub nurse, and surgeon were 390, 373.36, and 802 µSv, respectively. 

The personnel recommended limit dose rate was <20000 µSv/y. The technical factor used and total exposure time from this study could have affected the radiation dose. This study showed that personnel was safe even without the use of lead apron. Nevertheless, the use of an appropriate protective device should be encouraged to ensure safety.