Keeping Cool in the Operating Room

To the Editor: In the operating room, the ambient temperature might be uncomfortably warm for the surgical team, for several reasons. During off-pump surgery, the temperature might purposely be kept high. Without use of the heart-lung machine, it is important to avoid overcooling the patient, because rewarming can be difficult and take time. In tropical countries during summer, the atmospheric temperature might be so high that effective indoor cooling cannot be achieved. In some countries, power outages occur frequently, and uninterrupted electrical power is allocated to crucial infrastructure. Meanwhile, the surgical team is gowned and needs to stay focused. We have devised a simple way to remain cool. A ClearView® Blower/Mister (Medtronic, Inc.; Minneapolis, Minn) is used to direct a jet of oxygen toward the surgeon, at a flow rate of only 2 to 3 L/min. This device—a fixture in our operating room for 10 years now—is kept outside the sterile field, at the anesthesiologist's side. Apart from the cooling, we think that the high oxygen concentration sharpens our senses and improves our surgical focus.