Rovesti S, Pecone L F, Vivoli G
Dipartimento di Scienze Igienistiche, Microbiologiche e Biostatistiche, Università degli Studi di Modena e Reggio Emilia.
Ann Ig. 2003 Sep-Oct;15(5):701-8.
An environmental survey was carried out in the operating theatres of an Emilian hospital (North Italy) to ascertain: if concentrations of nitrous oxide (N2O) and isoflurane were within prescribed limits; if anesthetic pollution decreases when it is periodically controlled; if the degree of pollution from isoflurane can be predicted from N2O measurements. Three controls of anesthetic pollution were carried out at six month intervals using a photoacoustic spectrometry analyser. Mean concentrations of N2O were lower than the limits prescribed for renovated (50 ppm) or not refurbished (100 ppm) operating theatres in 58% of the surgical sessions examined. Mean concentrations of isoflurane were lower than the values proposed for halogenated anesthetics, used together with N2O (0.5 ppm) or alone (2 ppm) in 39% of the cases. Anesthetic pollution decreased only after the second control. Mean concentrations of isoflurane and N2O were correlated with a very good degree of association (r = 0.77). The survey highlights that pollution needs to be controlled in operating room because anesthetic levels often exceed the prescribed limits. Awareness of the problem is important to improve environmental conditions. N2O measurement is indicative of pollution from isoflurane but halogenated anesthetic must also be determined for a thorough evaluation of anesthetic pollution.
在意大利北部艾米利亚一家医院的手术室进行了一项环境调查,以确定:一氧化二氮(N₂O)和异氟烷的浓度是否在规定限度内;定期控制麻醉污染时其是否会降低;能否根据N₂O测量值预测异氟烷的污染程度。使用光声光谱分析仪每隔六个月对麻醉污染进行三次控制测量。在所检查的手术过程中,58%的情况下N₂O的平均浓度低于翻新手术室规定的限度(50 ppm)或未翻新手术室规定的限度(100 ppm)。在39%的病例中,异氟烷的平均浓度低于与N₂O联合使用(0.5 ppm)或单独使用(2 ppm)时卤化麻醉剂建议的数值。仅在第二次控制测量后麻醉污染才有所降低。异氟烷和N₂O的平均浓度具有非常好的相关性(r = 0.77)。该调查强调手术室的污染需要加以控制,因为麻醉剂水平常常超过规定限度。认识到这个问题对于改善环境条件很重要。N₂O测量可指示异氟烷的污染,但为了全面评估麻醉污染,还必须测定卤化麻醉剂。