Blokker-Veldhuis M J, Rutten P M M J, De Hert S G
Department of Clinical Perfusion, Academic Medical Center, Amsterdam, The Netherlands.
Perfusion. 2011 Sep;26(5):383-9. doi: 10.1177/0267659111409971. Epub 2011 May 18.
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.
挥发性麻醉剂广泛用于各类外科手术的麻醉维持。尽管采取了诸如手术室充分通风和使用高效废气清除系统等措施，但职业暴露风险仍受关注，尤其是在麻醉气体浪费风险增加的情况下，如在体外循环中使用挥发性麻醉剂时。本研究报告了一项初步安全性评估的结果，该评估涉及对心脏外科手术室环境空气中七氟醚浓度的测量。在22例进行体外循环的心脏外科手术中（11例使用开放静脉储血器，11例使用闭合静脉储血器），每隔10分钟在以下部位进行痕量浓度测量：氧合器出口处、心内吸引储血器出口处、灌注师呼吸区域以及手术野上方。使用光声红外光谱仪在线测量浓度。在整个观察期内，不同测量部位的七氟醚废气平均浓度始终低于推荐的目标值4.68 ppm。这些结果表明，在体外循环中使用七氟醚时，只要手术室通风和废气清除操作得当，职业暴露推荐水平不会被超过。
