SEVOFLURANE CONTAMINATION DURING PEDIATRI C BRONCHOSCOPY

Citation
K. Westphal et al., SEVOFLURANE CONTAMINATION DURING PEDIATRI C BRONCHOSCOPY, Anasthesist, 46(8), 1997, pp. 677-682
Citations number
26
Language
TEDESCO
art.tipo
Article
Categorie Soggetti
Anesthesiology
Journal title
ISSN journal
0003-2417
Volume
46
Issue
8
Year of publication
1997
Pages
677 - 682
Database
ISI
SICI code
0003-2417(1997)46:8<677:SCDPCB>2.0.ZU;2-H
Abstract
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.