The Relative Exposure of the Operating Room Staff to Sevoflurane During Intracerebral Surgery

Tankó, Béla; Molnár, Csilla; Büdi, Timea; Peto, C.; Novák, László; Fülesdi, Béla

doi:10.1213/ane.0b013e3181b0cbea

Cited by 22 publications

(11 citation statements)

References 19 publications

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“…to restore visibility), is therefore accompanied by the release of sevoflurane vapor. Hence, it is an additional source of waste anaesthetic gas (WAG) pollution [59,60,[63][64][65][66][67][68][69][70][71][72][73][74][75][76][77][78][79]. Known sources of WAG pollution include leakage from the patient's mask, from endotracheal coupling, from loose tube fittings and from air exhaled by the patient in the recovery room.…”

Section: Discussionmentioning

confidence: 99%

Chemical analysis of surgical smoke by infrared laser spectroscopy

Gianella

Sigrist

2012

Appl. Phys. B

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The chemical composition of surgical smoke, a gaseous by-product of some surgical devices-lasers, drills, vessel sealing devices-is of great interest due to the many toxic components that have been found to date. For the first time, surgical smoke samples collected during routine keyhole surgery were analyzed with infrared laser spectroscopy. Traces (ppm range) of methane, ethane, ethylene, carbon monoxide and sevoflurane were detected in the samples which consisted mostly of carbon dioxide and water vapor. Except for the anaesthetic sevoflurane, none of the compounds were present at dangerous concentrations. Negative effects on the health of operation room personnel can be excluded for many toxic compounds found in earlier studies, since their concentrations are below recommended exposure limits.

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Section: Discussionmentioning

confidence: 99%

Chemical analysis of surgical smoke by infrared laser spectroscopy

Gianella

Sigrist

2012

Appl. Phys. B

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“…Several studies have, indeed, indicated that operating room personnel are at risk from such increased occupational exposure. This risk is increased in situations of insufficient scavenging of waste gases and operating room ventilation and in situations where the operating room personnel work close to places where the spillage occurs 4,5,7,[17][18][19][20] .…”

Section: Discussionmentioning

confidence: 99%

Occupational exposure to sevoflurane during cardiopulmonary bypass

2011

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Volatile anaesthetic agents are widely used for maintenance of anaesthesia in all kinds of surgical procedures. Despite the implementation of measures such as adequate ventilation of the operating room and the use of efficient scavenging systems, concern remains about the risks for occupational exposure, especially in situations associated with an increased risk of anaesthetic gas waste, such as with the use of volatile anaesthetic agents on cardiopulmonary bypass. The present contribution reports the results of a preliminary safety assessment involving measurements of sevoflurane concentrations in the ambient air of a cardiac surgery operating room. In 22 cardiac surgical procedures with cardiopulmonary bypass (11 with open and 11 with closed venous reservoir), measurements of trace concentrations were obtained every 10 min at the following sites: at the outlet of the oxygenator, at the outlet of the cardiotomy reservoir, in the breathing zone of the perfusionist and above the surgical field. The concentrations were measured on-line using a photoacoustic infrared spectrometer. Mean sevoflurane waste concentrations remained consistently below the recommended target value of 4.68 ppm throughout the observation period at the different measurement sites. These results indicate that, with the use of sevoflurane on cardiopulmonary bypass, the recommended levels for occupational exposure are not exceeded, provided adequate operation room ventilation and waste gas scavenging is performed.

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“…Pediatric anesthesia with face masks, laryngeal masks or cuffless tracheal tubes significantly increase the concentration of anesthetic gases in the operating room [2,3]. In a recent study, Tankó et al revealed that during intracerebral surgeries, the evaporated amount of sevoflurane is the highest at the anesthetist's breathing zone, the most important source of this leakage is the patients' mouth [4] and the amount of evaporated gas is independent of the endotracheal tube cuff pressure [5]. It has been also demonstrated that exposure of the anesthesia staff can be decreased by proper positioning of the anesthesia personnel during intracranial surgery [6].…”

Section: How Can Anesthetic Gases Get Into the Air Of Operating Rooms?mentioning

confidence: 99%

“…There are three basic types of sample collection to assess work environment: personal, areal and source samples. Collection of personal samples is the best approach to measure the overall exposure of workers, because it represents gas concentrations of the worker's breathing zone the best during the period of sample collection [4]. This is actually the most preferred method to measure workers' average exposure per unit of time, both in operating theaters and in post-anesthetic care units.…”

Section: How To Monitor the Degree Of Halogenated Anesthetic Gas Expomentioning

confidence: 99%

Occupational Hazards of Halogenated Volatile Anesthetics and their Prevention: Review of the Literature

Molnár¹

2014

J Anesth Clin Res

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The harmful effect of inhalational anesthetics on the working environment of anesthetists is one of most controversial areas, where speculations can easily arise. In the present review the authors summarize the possible sources of environmental pollution in the operating theatre with special emphasis on the importance of air suctioning and air conditioning systems. A full-spectrum of the previously published animal and human studies is provided about the possible health hazards of inhalational agents including effects on the central nervous, reproductive and hematologic systems, on the liver functions and also on the carcinogenesis. A list of the proposed measures to decrease pollution to the minimum in the operating theatre environment is provided. It is concluded that according to the present knowledge, the use of inhalational agents may be considered safe if the prescribed limits of halogenated anesthesia gases are met.

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The Relative Exposure of the Operating Room Staff to Sevoflurane During Intracerebral Surgery

Abstract: The close proximity of the surgeon's breathing zone to the craniotomy window does not appear to be a source of increased exposure to sevoflurane. The observed higher exposure of the anesthesiologist to sevoflurane in the operating room environment warrants further exploration.

Cited by 22 publications

References 19 publications

Chemical analysis of surgical smoke by infrared laser spectroscopy

Chemical analysis of surgical smoke by infrared laser spectroscopy

Occupational exposure to sevoflurane during cardiopulmonary bypass

Occupational Hazards of Halogenated Volatile Anesthetics and their Prevention: Review of the Literature

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