The Anesthetic Gas Monitoring
The measurement of occupational exposure to pollutants in the operating room is an essential tool for the detection of chemical, linked not only to the occurrence of infections and various diseases, but also to reduced alertness and performance of staff. To meet the above requirements, ETG proposes the use of ‘INFRARUN, thanks to the high sensitivity and stability and the very wide dynamic range, INFRARUN is the ideal tool to make a continuous sampling in the short and long-term gaseous contaminants in the field hospital, such as volatile anesthetics, aldehydes, fluorani, isofluorani,, VOC’s, etc.
One of the most sensitive about safety in the operating room is the chemical risk due to the presence of anesthetic gases in the air. They do all health facilities that have written internal procedures and quality control.
What is it and where we find
The risk from occupational exposure regards general anesthesia, obtained by administration of halogenated.
Among the halogenated anesthetics, the ones most commonly used are:
- halothane (fluotano);
- methoxyflurane (pentane);
- enflurane (ethrane);
- isoflurane (isoflurane);
- sevoflurane (sevoflurane).
- In addition to the halogenated we have:
- nitrous oxide
- carbon dioxide
- etc ….
Anesthetics are used, as well as in the operating room, also in certain radiology rooms and in some surgeries.
The use of anesthetic gases can lead to pollution of the environment, resulting in occupational exposure of operators.
The great interest to the pollution of anesthetic gases and vapors in operating rooms is linked to the proven toxic action of these substances, resulting in risk for all personnel occupationally exposed (anesthesiologists, surgeons, and nurses ferristi of room).
The degree of environmental pollution, from surveys carried out in several Italian hospitals and ISPESL (Inspectorate for Prevention and Safety at Work), seems to be rather high to achieve during the course of surgery, especially during the induction of anesthesia , values of 300-400 up to 1000 ppm of isoflurane and enflurane.
Before examining the causes of environmental pollution of operating theaters is necessary to dwell on a description, in general terms, systems of induction and anesthesia equipment.
The problem of pollution does not only affects the operating room but also, although to a lesser extent, the environments adjacent to it: the salt wash of the instruments, sterilization, preparation for surgeons, the access corridors and in particular the salt “awakening”, in which the patient, continuing to exhale air to a high concentration of anesthetic, determines a high rate of environmental pollution.
The limit values
In the third paragraph of the Circular are specified limit values (TLV-TWA) and the ACGIH (American Conference of Governmental Industrial Hygienists, 1990-91) recommends to the anesthetic substances most frequently used:
· Halothane 50 ppm 400 mg / m
· Enflurane 75 ppm equal to 575 mg / m
· Isoflurane 75 ppm (2 ppm when combined with N2O)
· 50 ppm N2O equal to 91 mg / cu m for operating theaters in the case of new construction or renovation
· 100 ppm for existing operating rooms