Schuyt H C, Verberk M M
Occupational Health & Safety and Environmental Hygiene Service, University of Amsterdam, The Netherlands.
J Occup Environ Med. 1996 Oct;38(10):1036-40. doi: 10.1097/00043764-199610000-00015.
In a program designed to lower exposure to anesthetic gases, nitrous oxide in the breathing zone of anesthesiologists was continuously monitored by means of a direct reading apparatus and a specially designed collar. Initially, the average concentration during anesthesia in intubated patients, determined in 30 operating rooms of seven hospitals, was 68 ppm. During mask anesthesia in children, it was 407 ppm (nine operating rooms, nine hospitals). The main hygienic measures were: a check of the anesthesia apparatus, improvement of the general ventilation in the operating room, and the application of a "double mask." With a combination of measures, the concentration during anesthesia in intubated patients was reduced from 61-90 ppm to 2-15 ppm. During mask anesthesia in children, the concentration decreased from 134-764 ppm to 9-42 ppm. The monitoring system used reveals important differences in the exposure during the separate phases of the anesthesia (induction, maintenance, and extubation). It also indicates which factors determine the exposure of the anesthetist and allows accurate determination of the personal exposure.
在一个旨在降低麻醉气体暴露的项目中，通过直读仪器和一种专门设计的项圈，对麻醉医生呼吸区域的一氧化二氮进行了持续监测。最初，在七家医院的30个手术室中测定的插管患者麻醉期间的平均浓度为68 ppm。在儿童面罩麻醉期间，该浓度为407 ppm（九家医院的九个手术室）。主要的卫生措施包括：检查麻醉设备、改善手术室的整体通风以及使用“双层面罩”。通过综合这些措施，插管患者麻醉期间的浓度从61 - 90 ppm降至2 - 15 ppm。在儿童面罩麻醉期间，浓度从134 - 764 ppm降至9 - 42 ppm。所使用的监测系统揭示了麻醉不同阶段（诱导、维持和拔管）暴露情况的重要差异。它还指出了哪些因素决定麻醉医生的暴露水平，并能准确测定个人暴露情况。
