Hoerauf K H, Hartmann T, Acimovic S, Kopp A, Wiesner G, Gustorff B, Jellinek H, Krafft P
Department of Anaesthesiology and General Intensive Care, University of Vienna, Austria.
Br J Anaesth. 2001 Jan;86(1):124-6. doi: 10.1093/bja/86.1.124.
Exposure to sevoflurane (SEV) and nitrous oxide during ventilation using a Combitube (37Fr) small adult (SA) was compared with waste gas exposure using conventional endotracheal tubes. Trace concentrations of SEV and nitrous oxide were assessed using a direct reading spectrometer during 40 gynaecological laparoscopic procedures under general anaesthesia. Measurements were made at the patients' mouth and in the anaesthetists' breathing zone. Mean (SD) concentrations of SEV and nitrous oxide measured at the patients' mouth were comparable in the Combitube SA (SEV 0.6 (0.2) p.p.m.; nitrous oxide 9.7 (8.5) p.p.m.) and endotracheal tube group (SEV 1.2 (0.8) p.p.m.; nitrous oxide 17.2 (10.6) p.p.m.). These values caused comparable contamination of the anaesthetists' breathing zone (SEV 0.6 (0.2) p.p.m. and nitrous oxide 4.3 (3.7) p.p.m. for the Combitube SA group, compared with SEV 0.5 (0.2) p.p.m. and nitrous oxide 4.1 (1.8) p.p.m. for the endotracheal tube group). We conclude that the use of the Combitube SA during positive pressure ventilation is not necessarily associated with increased waste gas exposure, especially when air conditioning and scavenging devices are available.
在使用成人小号（SA）37Fr食管气管联合导管通气期间，将七氟醚（SEV）和一氧化二氮的暴露情况与使用传统气管内导管时的废气暴露情况进行了比较。在40例全身麻醉下的妇科腹腔镜手术过程中，使用直读光谱仪评估SEV和一氧化二氮的痕量浓度。在患者口腔和麻醉医生呼吸区域进行测量。在食管气管联合导管SA组（SEV 0.6（0.2）ppm；一氧化二氮9.7（8.5）ppm）和气管内导管组（SEV 1.2（0.8）ppm；一氧化二氮17.2（10.6）ppm）中，在患者口腔测得的SEV和一氧化二氮的平均（标准差）浓度相当。这些值导致麻醉医生呼吸区域的污染相当（食管气管联合导管SA组SEV 0.6（0.2）ppm，一氧化二氮4.3（3.7）ppm，而气管内导管组SEV 0.5（0.2）ppm，一氧化二氮4.1（1.8）ppm）。我们得出结论，在正压通气期间使用食管气管联合导管SA不一定会增加废气暴露，尤其是在有空调和废气清除装置的情况下。
