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麻醉后护理单元内患者及护理人员呼吸区域内废麻醉气体的评估与控制。

Evaluation and control of waste anesthetic gas in the postanesthesia care unit within patient and caregiver breathing zones.

作者信息

Williams George W, Gumbert Sam D, Pivalizza Evan G, Syed Tariq A, Burnett Tyrone, Mancillas Omar L, Vargas Leslie A, Ahn Stephanie H, Cai Chunyan, Hagberg Carin A

机构信息

Department of Anesthesiology, The University of Texas Health Science Center at Houston, McGovern Medical SchoolHoustonTexas.

Department of Neurosurgery, The University of Texas Health Science Center at Houston, McGovern Medical SchoolHoustonTexas.

出版信息

Proc (Bayl Univ Med Cent). 2018 Dec 20;32(1):43-49. doi: 10.1080/08998280.2018.1502017. eCollection 2019 Jan.

Abstract

This study (NCT02428413) evaluated waste anesthetic gas (WAG) in the postanesthesia care unit (PACU) and assessed the utility of the ISO-Gard mask in reducing nursing exposure to WAG. We hypothesized that WAG levels in the patient's breathing zone upon recovery would exceed the recommended levels, leading to increased exposure of the PACU nurses, with use of the ISO-Gard mask limiting this exposure. A total of 125 adult patients were recruited to participate. Patients were randomized to receive the standard oxygen delivery mask or the ISO-Gard face mask postoperatively. Continuous particulate concentrations were measured using infrared spectrophotometers placed within the patients' and nurses' 6-inch breathing zone. Maximum WAG measurements were obtained every 30 seconds, and the duration of maximum WAG >2 ppm and its proportion relative to the total collection period were calculated. We observed a statistically significant difference in desflurane duration and proportion of maximum WAG >2 ppm in both patient and PACU nurse breathing zones. Therefore, patients and PACU nurses using routine care were exposed to WAG levels >2 ppm during the 1-hour postoperative period, and the ISO-Gard mask effectively reduced the amount of WAG detected in the immediate 1-hour postoperative recovery phase.

摘要

本研究(NCT02428413)评估了麻醉后护理单元(PACU)中的废麻醉气体(WAG),并评估了ISO - Gard面罩在减少护士接触WAG方面的效用。我们假设患者恢复时呼吸区域内的WAG水平会超过推荐水平,导致PACU护士接触增加,而使用ISO - Gard面罩可限制这种接触。共招募了125名成年患者参与。患者术后被随机分配接受标准输氧面罩或ISO - Gard面罩。使用放置在患者和护士6英寸呼吸区域内的红外分光光度计测量连续颗粒物浓度。每30秒获取一次最大WAG测量值,并计算最大WAG>2 ppm的持续时间及其占总收集期的比例。我们观察到在患者和PACU护士呼吸区域内,地氟烷持续时间以及最大WAG>2 ppm的比例存在统计学显著差异。因此,采用常规护理的患者和PACU护士在术后1小时内接触的WAG水平>2 ppm,而ISO - Gard面罩在术后即刻1小时恢复阶段有效减少了检测到的WAG量。

相似文献

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Exposure of postoperative nurses to exhaled anesthetic gases.术后护士接触呼出的麻醉气体情况。
Anesth Analg. 1998 Nov;87(5):1083-8. doi: 10.1097/00000539-199811000-00019.

本文引用的文献

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Management of exposure to waste anesthetic gases.废弃麻醉气体暴露的管理
AORN J. 2010 Apr;91(4):482-94. doi: 10.1016/j.aorn.2009.10.022.
7
Exposure of postoperative nurses to exhaled anesthetic gases.术后护士接触呼出的麻醉气体情况。
Anesth Analg. 1998 Nov;87(5):1083-8. doi: 10.1097/00000539-199811000-00019.
9
A review of the effects of trace concentrations of anaesthetics of performance.
Br J Anaesth. 1978 Jul;50(7):701-12. doi: 10.1093/bja/50.7.701.

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