General anaesthetic agents are frequently used for paediatric bronchos
copy. A disadvantage of open-system anaesthesia is the contamination o
f the working environment. The aim of this study was to determine the
exposure of the anaesthesiologist and endoscopist during paediatric br
onchoscopy under general anaesthesia in different working environments
and to compare these measurements to the currently valid internationa
l threshold limits. Materials and methods: Twenty-five children (ASA I
-III) scheduled for diagnostic bronchoscopy were included in the study
. After inhalational induction, all patients were intubated with a non
flexible bronchoscope and manually ventilated through a side-arm of th
e bronchoscope. Maintenance of anaesthesia was achieved with sevoflura
ne (2-3 vol.%) in pure oxygen. Trace concentrations were measured ever
y 90 s in the breathing zones of the operating theatre (OT) personnel
by means of a highly sensitive direct-reading instrument (Bruel & Kjae
r 1302). The tower detection limit was 0.02 ppm. The investigation was
done in an OT with and without air-conditioning and a scavenging syst
em. Results: The mean age of the children was 50.3 months (range: 3-10
9 months). Ventilation and oxygenation were stable throughout the bron
choscopic procedure. Mean exposure to sevoflurane in the Or without ai
r-conditioning and a scavenging system was over 40 ppm for the anaesth
etist and 50 ppm for the endoscopist. All international threshold limi
t values were exceeded. Peak concentrations higher than 100 ppm could
be detected during 40% of the anaesthetics. Conclusion: the main findi
ng of the present study is that under inhalation anaesthesia with sevo
flurane for paediatric bronchoscopy, occupational exposure is higher t
han all known health regulation guidelines permit. Therefore, the use
of total intravenous anaesthesia is advocated even in very small infan
ts.