Marx T, Zwing M, Köble R, Fröba G, Klampp D, Georgieff M
Universitätsklinik für Anästhesiologie, Universität Ulm.
Anasthesiol Intensivmed Notfallmed Schmerzther. 1998 Jan;33(1):27-31. doi: 10.1055/s-2007-994206.
In the Federal Republic of Germany limits for the chronic exposure to nitrous oxide and volatile anaesthetics have been prescribed by legislation. According to the technical rules for the handling of hazardous substances TRGS 402 it is legal to measure a single substance in a mixture of hazards, unless the behaviour of all substances is known. Studies about corresponding concentrations of nitrous oxide and volatile anaesthetics in anaesthetic working areas have not yet been carried out.
During one working week each the concentrations of nitrous oxide, enflurane and desflurane were measured by infrared spectrometry in a working area equipped with air condition and in a non-ventilated operating theatre. Corresponding concentrations of nitrous oxide were measured from the same gas samples.
Statistical calculations showed linear correlations of the enflurane and nitrous oxide concentrations in all anaesthetic areas. No linear regression was found between the desflurane and nitrous oxide concentrations. In the working area where desflurane anaesthesias were carried out, significantly higher concentrations of nitrous oxide were observed. Nevertheless the Chi2-test showed no significant differences in the distribution of categorised measurement values.
Although it is not possible to calculate desflurane concentrations from the nitrous oxide concentrations, measurement of nitrous oxide as leading substance is a valid procedure to assess the exposure of the anaesthesiology workplace to nitrous oxide and volatile anaesthetics. Significant higher nitrous oxide concentrations during desflurane anaesthesia result from early extubation of patients expiring higher concentrations of nitrous oxide.
在德意志联邦共和国，已通过立法规定了长期接触氧化亚氮和挥发性麻醉剂的限值。根据有害物质处理技术规则TRGS 402，在危险混合物中测量单一物质是合法的，除非所有物质的行为都已知。尚未对麻醉工作区域中氧化亚氮和挥发性麻醉剂的相应浓度进行研究。
在一个工作周内，通过红外光谱法在配备空调的工作区域和无通风的手术室中分别测量氧化亚氮、恩氟烷和地氟烷的浓度。从相同的气体样本中测量氧化亚氮的相应浓度。
统计计算表明，在所有麻醉区域中恩氟烷和氧化亚氮浓度呈线性相关。在地氟烷和氧化亚氮浓度之间未发现线性回归。在进行地氟烷麻醉的工作区域，观察到氧化亚氮浓度明显更高。然而，卡方检验表明分类测量值的分布没有显著差异。
尽管无法从氧化亚氮浓度计算地氟烷浓度，但将氧化亚氮作为主要物质进行测量是评估麻醉工作场所接触氧化亚氮和挥发性麻醉剂的有效方法。地氟烷麻醉期间氧化亚氮浓度显著升高是由于患者早期拔管呼出较高浓度的氧化亚氮所致。
