Puri G D, Meena Shyam C, Sinha Vinayak, Hazarika Amarjyoti, Hakkim Haseeb, Sharma Ashish, Kajal Kamal, Dogra Neeti
Post Graduate Institute Medical Education and Research, Chandigarh, India.
Indian Institute of Science Education and Research, Mohali, Punjab, India.
Indian J Occup Environ Med. 2021 Jul-Sep;25(3):147-151. doi: 10.4103/ijoem.IJOEM_44_19. Epub 2021 Oct 9.
Nitrous oxide has been used during surgical anesthesia for many years. However, information about occupational exposure and related risks due to NO exposure to the health care personnel in India are still poorly understood. Here, we measured the residual NO levels during the working time of operation theatre room air in our tertiary care hospital.
The air samples were collected from different anesthesia exposure zones on different days for quantitative analysis of available NO in the room air in respective areas. Nitrous oxide concentrations in the ambient air were also measured to compare outdoor and indoor levels.
Nitrous oxide mixing ratios were found to be 65.61 ± 0.05 ppm, 281.63 ± 0.43 ppm, and 165.42 ± 0.42 ppm in elective surgical theatres of the hospital on three different days whereas in emergency operation theatres of the same hospital levels of NO were 166.75 ± 0.07 ppm, 510.19 ± 0.30 ppm and 2443.92 ± 0.64 ppm during same period. In elective pediatric surgical theatres levels of NO were found to be 1132.55 ± 0.70 ppm and 362.21 ± 0.13 ppm on two days of reading respectively. Outdoor levels of NO in contrast found 0.32 ± 0.01 ppm and was lower by a factor of 1000.
We observed the very high ambient concentration of NO in the surgical theatre's environment (up to 2443 ppm) and recovery areas (up to 50 ppm). It was 5 to 50 times higher ambient concentration of NO than REL in OT area and 200-7000 times higher ambient concentration of NO than outdoor ambient air in all surgical theaters other than CTVS OTs.
氧化亚氮在外科麻醉中已使用多年。然而，在印度，医护人员因接触氧化亚氮而导致的职业暴露及相关风险仍知之甚少。在此，我们测量了我院三级护理医院手术室空气中在工作时间内的氧化亚氮残留水平。
在不同日期从不同麻醉暴露区域采集空气样本，以对各区域室内空气中的有效氧化亚氮进行定量分析。还测量了环境空气中的氧化亚氮浓度，以比较室外和室内水平。
在该医院择期手术麻醉室，三个不同日期的氧化亚氮混合比分别为65.61±0.05 ppm、281.63±0.43 ppm和165.42±0.42 ppm；而在同一医院的急诊手术室，同期氧化亚氮水平分别为166.75±0.07 ppm、510.19±0.30 ppm和2443.92±0.64 ppm。在择期小儿外科手术室，两次读数时氧化亚氮水平分别为1132.55±0.70 ppm和362.21±0.13 ppm。相比之下，室外氧化亚氮水平为0.32±0.01 ppm，低了1000倍。
我们观察到手术室环境（高达2443 ppm）和恢复区域（高达50 ppm）中氧化亚氮的环境浓度非常高。在除心血管外科手术室之外的所有手术室中，其氧化亚氮环境浓度比手术室区域的职业接触限值高5至50倍，比室外环境空气高200 - 7000倍。
