Benzine-Induced Operating Room Fire: A Rare but Preventable Anesthesia Hazard

Introduction:

Operating room fires remain a critical concern in surgical safety despite technological advances and stricter protocols. One overlooked threat—benzine—was identified as a key fuel source in a recent clinical case report involving a patient undergoing minor surgery. This incident serves as a potent reminder of the importance of hazard awareness, particularly concerning flammable materials in anesthetic environments.
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Clinical Case Summary: A Hidden Fire Hazard Unveiled

• A 43-year-old male with a history of substance abuse underwent spinal anesthesia for removal of myiasis (larvae infestation).
• Electrocautery was used during the procedure, unknowingly near benzine stored in a sterile container for larval disposal.
• The vapor from benzine ignited, causing burns to the patient and minor injuries to the surgical team.
• Quick action from the staff, including cessation of oxygen flow and activation of fire control, prevented a catastrophic escalation.

Read the full study at: https://doi.org/10.29328/journal.ijcar.1001011

Understanding the Dangers of Benzine in Clinical Settings

Benzine, or petroleum ether, is a clear and highly flammable hydrocarbon solvent with a boiling point of 35–60°C. Though rarely seen in surgical use, its volatility becomes a lethal factor when exposed to ignition sources like electrosurgical units.

The American Society of Anesthesiologists (ASA) underscores in its safety guidelines that fuel sources, oxidizers, and ignition devices should never coexist within close proximity in the operating room. Benzine’s unnoticed presence violates this core principle of surgical fire prevention.

Broader Implications and Protocol Recommendations

• Avoid flammable agents: Alcohol-based antiseptics and solvents such as benzine must be carefully monitored.
• Oxygen management: Maintain oxygen concentration below 30% during procedures, especially above the intermamillary line.
• Use structured assessments: The Fire Risk Assessment Tool by Spruce L. offers a five-question checklist to identify potential risks before surgery.
• Training and response: Hospitals should maintain a well-trained fire response team and rehearse containment protocols regularly.

The Joint Commission also advocates integrating fire prevention protocols into every surgical checklist to mitigate OR fire risks and enhance patient safety standards.

A detailed analysis can be found in our main journal article.

You can also explore more related safety content in our Clinical Anesthesia category .

Key Takeaways:

• Never introduce benzine or other volatile substances into the OR.
• Coordinate between anesthesiologists and surgeons regarding any material introduced near the surgical field.
• Maintain oxygen concentration within safe limits.
• Enforce the use of safety checklists such as Spruce’s Fire Risk Assessment Tool.

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