Evaluation and Control of Waste Anesthetic Gases in the Postanesthesia Care Unit

McGlothlin, James D.; Moenning, John E.; Cole, Sandra S.

doi:10.1016/j.jopan.2013.09.010

Cited by 16 publications

(18 citation statements)

References 27 publications

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“…[12], but demonstrate an increased scavenging effect with the ISO-Gard mask, possibly due to either our use of higher oxygen flow rates (6 l.min ) and suction pressures (40 mmHg vs. 30 mmHg), and/or our practice of extubating patients' trachea in theatre rather than in the recovery unit. Transition of the extubated patient may have diluted the exhaled anaesthetic agents we recorded en route.…”

Section: Discussionmentioning

confidence: 84%

“…To ensure there was no potential conflict of interest beyond the MIRAN hire, a medical student employed by neither Teleflex nor Salford Royal NHS Foundation Trust performed the measurements. The study protocol was devised independently from Teleflex, after careful appraisal of the previous pilot study [12]. No other external funding or competing interests declared.…”

Section: Acknowledgementsmentioning

confidence: 99%

“…One-way valves allow entrainment of supplemental room air, but prevent the escape of exhaled gases into the atmosphere. The manufacturer claims this device scavenges waste anaesthetic agents effectively, based on data from a small pilot study undertaken by investigators with a financial conflict of interest [12].…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of a novel waste anaesthetic gas scavenger device for use during recovery from anaesthesia

2017

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SummaryVolatile anaesthetic agents are a potential occupational health hazard to theatre and recovery staff. Operating theatres and anaesthetic rooms are required to be equipped with scavenging systems, but recovery units often are not. We compared exhaled, spectrophotometric sevoflurane and desflurane concentrations 15 cm from the mouth ('patient breathing zone') and 91 cm laterally to the patient ('nurse work zone') in 120 patients after tracheal extubation who were consecutively allocated to either ISO-Gard mask oxygen/scavenging or standard oxygen mask, 0 min, 10 min and 20 min after arrival in the theatre recovery unit. Median (IQR [range]) duration of anaesthesia was similar between groups (control 76 (44-119 [15-484]) min vs. study group 90 (64-130 [15-390]) min, p = 0.136). Using the ISO-Gard mask, the 20-min mean patient breathing zone and nurse work zone exhaled anaesthetic levels werẽ 90% and 78% lower than those recorded in the control group, respectively, and were within the recommended 2 ppm maximum environmental exposure limit in the patient breathing zone of 53 out of 60 (88%) and the nurse work zone of all 60 (100%) patients on first measurement in the recovery room (vs. 10 out of 60 (17%) and 40 out of 60 (67%) in the control group). Our study indicates that the ISO-Gard oxygen/scavenging mask reduces the level of exhaled sevoflurane and desflurane below recommended maximum exposure limits near > 85% of extubated patients within~20 s of application in the recovery unit after surgery. We encourage the use of this mask to minimise the occupational exposure of recovery staff to exhaled volatile agents.

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Section: Discussionmentioning

confidence: 84%

Section: Acknowledgementsmentioning

confidence: 99%

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Evaluation of a novel waste anaesthetic gas scavenger device for use during recovery from anaesthesia

2017

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“…19 In that study, 19 adult patients who had general anesthesia with sevoflurane (with or without nitrous oxide) were studied. All patients were tracheally intubated upon their arrival in the PACU, and measurements were started after tracheal extubation.…”

Section: Discussionmentioning

confidence: 99%

“…Various source control systems have been studied and have been shown to be useful in controlling the amount of WAG, including the AirCare Source Control System and the IsoGard Ò mask. 1,19 Other work practices have been suggested, such as avoiding the patient's breathing zone whenever possible, especially when they are coughing or talking, and charting the patient's record at the foot of the bed. These measures, together with a well-maintained effective ventilation system, are keys to minimizing WAG levels and occupational exposure in the PACU.…”

Section: Discussionmentioning

confidence: 99%