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Rev Esp Anestesiol Reanim. 2014 Mar;61(3):133-9. doi: 10.1016/j.redar.2013.11.011. Epub 2014 Jan 15.

Health worker exposure risk during inhalation sedation with sevoflurane using the (AnaConDa®) anaesthetic conserving device.

Author information

1
Servicio de Anestesiología y Reanimación, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. Electronic address: rgonzalezr@santpau.cat.
2
Servicio de Riesgos Laborales y Medicina Preventiva, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
3
Servicio de Anestesiología y Reanimación, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.

Abstract

INTRODUCTION AND OBJECTIVE:

Occupational exposure to sevoflurane should not exceed 2 ppm. During inhalation sedation with sevoflurane using the anaesthetic conserving device (AnaConDa(®)) in the post-anaesthesia care unit, waste gases can be reduced by gas extraction systems or scavenging devices such as CONTRAfluran™. However, the efficacy of these methods has not been clearly established. To determine the safest scenario for healthcare workers during inhalation sedation with sevoflurane in the post-surgical intensive care unit.

MATERIALS AND METHODS:

An experimental study on occupational exposure was conducted in a post-cardiothoracic care unit during March-August 2009. The measurements were performed in four post-cardiac surgery sedated adults in post-surgical intensive care unit and four nurses at the bedside, and at four points: scenario A, inhalation sedation without gas extraction system or contrafluran as a reference scenario; scenario B, applying a gas extraction system to the ventilator; scenario C, using contrafluran; and scenario 0, performing intravenous isolation sedation. Sevoflurane concentrations were measured in the nurses' breathing area during patient care, and at 1.5 and 8 m from the ventilator using diffusive passive monitor badges.

RESULTS:

All badges corresponding to the nurses' breathing area were below 2 ppm. Levels of sevoflurane detected using prevention systems were lower than that in the control situation. Only one determination over 2 ppm was found, corresponding to the monitor placed nearest the gas outlet of the ventilator in scenario A. Trace concentrations of sevoflurane were found in scenario 0 during intravenous sedation.

CONCLUSIONS:

Administration of sevoflurane through the AnaConDa(®) system during inhalation sedation in post-surgical intensive care units is safe for healthcare workers, but gas extraction systems or scavenging systems, such as CONTRAfluran™ should be used to reduce occupational exposure as much as possible.

KEYWORDS:

Cuidados intensivos postoperatorios; Exposición profesional; Inhalation sedation; Post-surgical intensive care unit; Professional exposure; Sedación inhalatoria; Sevoflurane; Sevoflurano

PMID:
24439525
DOI:
10.1016/j.redar.2013.11.011
[Indexed for MEDLINE]

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