Byhahn C, Wilke H J, Strouhal U, Kessler P, Lischke V, Westphal K
Department of Anesthesiology, Intensive Care Medicine, and Pain Control, J.W. Goethe-University Hospital Center, Frankfurt, Germany.
Can J Anaesth. 2000 Oct;47(10):984-8. doi: 10.1007/BF03024870.
To determine occupational exposure of the anesthesiologist and surgeon to nitrous oxide and desflurane during general anesthesia for ear-nose-throat (ENT) surgery in children and adults.
An observational clinical trial was performed in ten children (C) and ten adults (A). Tracheas were intubated, in adults, with cuffed tubes and in children with uncuffed tubes. The operating room was equipped with modern air conditioning and waste anesthetic gas scavengers. Gas samples were obtained during the operative procedure every 90 sec from the breathing zone of subjects. Time-weighted averages (TWA) over the time of exposure were calculated for nitrous oxide and desflurane.
Nitrous oxide TWAs for anesthesiologists were 0.41 +/- 0.23 ppm (A) and 1.20 +/- 0.32 ppm (C, P < 0.0001), and 2.24 +/- 1.93 ppm (A) and 5.30 +/- 0.60 ppm (C, P = 0.0001) for the surgeon who worked close to the patient's airway and thus had higher exposure (P < 0.05 [A], P < 0.0001 [C]). With regard to desflurane, the anesthesiologists' TWAs were 0.02 +/- 0.03 ppm for both adults and children. The surgeon was exposed to 0.21 +/- 0.24 ppm desflurane (A) and 0.30 +/- 0.14 ppm (C, P: n.s.). Although the surgeon's exposure was greater (P < 0.05 [A], P < 0.0001 [C]), the threshold limits of 25 ppm for nitrous oxide and 2 ppm for desflurane recommended by the National Institute of Occupational Safety and Health were not exceeded.
Under modern air conditioning, occupational exposure to inhalational anesthetics is low, and inhalational anesthesia is safe from the standpoint of modern workplace laws and health-care regulations.
确定在儿童和成人耳鼻喉（ENT）手术全身麻醉期间，麻醉医生和外科医生对氧化亚氮和地氟烷的职业暴露情况。
对10名儿童（C组）和10名成人（A组）进行了一项观察性临床试验。成人使用带套囊的气管导管插管，儿童使用无套囊的气管导管插管。手术室配备了现代空调和麻醉废气清除装置。在手术过程中，每隔90秒从受试者的呼吸区域采集气体样本。计算氧化亚氮和地氟烷在暴露时间内的时间加权平均值（TWA）。
麻醉医生的氧化亚氮TWA分别为0.41±0.23 ppm（A组）和1.20±0.32 ppm（C组，P<0.0001），靠近患者气道工作因而暴露程度更高的外科医生的氧化亚氮TWA分别为2.24±1.93 ppm（A组）和5.30±0.60 ppm（C组，P = 0.0001）（A组P<0.05，C组P<0.0001）。关于地氟烷，成人和儿童麻醉医生的TWA均为0.02±0.03 ppm。外科医生暴露于地氟烷的浓度为0.21±0.24 ppm（A组）和0.30±0.14 ppm（C组，P：无统计学意义）。尽管外科医生的暴露程度更高（A组P<0.05，C组P<0.0001），但未超过美国国家职业安全与健康研究所推荐的氧化亚氮25 ppm和地氟烷2 ppm的阈限值。
在现代空调条件下，职业性吸入麻醉剂暴露较低，从现代工作场所法律和医疗保健法规的角度来看，吸入麻醉是安全的。
