Anesthesiologists are chronically exposed to trace concentrations of sevoflurane during work. Inhalational inductions, LMA™, and TF air-conditioning systems in particular are associated with higher sevoflurane exposure. However, the amount of inhaled sevoflurane per day was lower than expected, perhaps because concentrations in previous measurements could be overestimated (10%-15%) because of the cross-sensitivity reaction.
Aim: Polyvinylpyrrolidone-iodine liposomal hydrogel (PVP-ILH) is a hydrogel formulation based on polyvinylpyrrolidone-iodine (PVP-I) and liposomes. The beneficial effects of PVP-ILH on wound healing have been previously shown. The aim of this study was to investigate the effects of topically applied PVP-ILH on wound microcirculation. Materials and Methods: Experiments were performed on wounds in male SKH1-hr hairless mice (n = 48). Mice were randomized into five treatment groups: mice treated with polyacrylic acid (PAA) and PAA 1:10 as well as PVP-ILH and PVP-ILH 1:10. Mice treated with sodium chloride served as control. Immediately as well as 3, 7, and 14 days after wounding, intravital fluorescent microscopy (IFM) was performed to determine wound surface area and standard microcirculatory parameters. Results: Topically administered PVP-ILH reduced wound size significantly faster compared to controls. Standard microcirculatory parameters, e.g. functional capillary density (FCD) and plasma leakage, showed no differences. FCD increases in all groups after wound creation. Using PVP-ILH, a trend towards higher FCD was observed. Conclusion: The wound model in hairless mice in combination with IFM is suitable to qualitatively assess wound microcirculation over a period of 2 weeks even after topical application of pigmented ointments. PVP-ILH showed a positive effect on dermal wound healing and wound microcirculation.
SummaryAlthough sevoflurane is commonly used in anaesthesia, a threshold value for maximum exposure to personnel does not exist and although anaesthetists are aware of the problem, surgeons rarely focus on it. We used a photo-acoustic infrared device to measure the exposure of surgeons to sevoflurane during paediatric adenoidectomies. Sixty children were randomly allocated to laryngeal mask, cuffed tracheal tube or uncuffed tracheal tube. The average mean (maximum) sevoflurane concentrations within the surgeons' operating area were 1.05 (10.05) ppm in the laryngeal mask group, 0.33 (1.44) ppm in the cuffed tracheal tube group and 1.79 (18.02) ppm in the uncuffed tracheal tube group, (p < 0.001), laryngeal mask and cuffed tracheal tube groups vs. uncuffed tube group. The presence of sevoflurane was noticed by surgeons in 20% of cases but there were no differences between the groups (p = 0.193). Surgical and anaesthetic complications were similar in all three groups. We conclude that sevoflurane can be safely used during adenoidectomies with all three airway devices, but in order to minimise sevoflurane peak concentrations, cuffed tracheal tubes are preferred.
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