Merlo Lisa J, Goldberger Bruce A, Kolodner Dara, Fitzgerald Kimberly, Gold Mark S
Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL 32610-0183, USA.
J Addict Dis. 2008;27(3):67-76. doi: 10.1080/10550880802122661.
Inflated rates of opioid addiction among anesthesiologists may be caused by chronic exposure to low doses of aerosolized anesthetic/analgesic agents in the operating room. Such secondhand exposure produces neurobiological sensitization to the reinforcing effects of these substances, making later addiction more likely. This article extends findings that fentanyl and propofol are detectable in the air of the operating room and demonstrates that fentanyl is also detectable on surfaces in the operating room. Secondhand exposure could, therefore, occur by inhalation and skin absorption. Additionally, data show that many physicians with opiate addiction have a family history of addiction, suggesting genetic vulnerability to the effects of secondhand exposure. Other new data demonstrate that the rates of marijuana and tobacco smoking are much higher among opioid-addicted physicians, suggesting that prior exposure to THC (the psychoactive component of cannabis) or nicotine might increase vulnerability to secondhand effects. Suggestions for reducing secondhand exposure in the operating room are discussed.
麻醉医生中过高的阿片类药物成瘾率可能是由于在手术室中长期接触低剂量的雾化麻醉/镇痛剂所致。这种二手接触会对这些物质的强化作用产生神经生物学致敏，从而使日后成瘾的可能性增加。本文扩展了关于在手术室空气中可检测到芬太尼和丙泊酚的研究结果，并证明在手术室的表面也可检测到芬太尼。因此，二手接触可能通过吸入和皮肤吸收发生。此外，数据显示许多有成瘾问题的医生有家族成瘾史，这表明存在对二手接触影响的遗传易感性。其他新数据表明，阿片类药物成瘾的医生中吸食大麻和烟草的比例要高得多，这表明先前接触四氢大麻酚（大麻的精神活性成分）或尼古丁可能会增加对二手影响的易感性。本文还讨论了减少手术室二手接触的建议。
