title: Occupational exposure to nitrous oxide and desflurane during ear-nose-throat-surgery.
abstract: OBJECTIVE
  To determine occupational exposure of the anesthesiologist and surgeon to nitrous oxide and desflurane during general anesthesia for ear-nose-throat (ENT) surgery in children and adults.
  
  
  METHODS
  An observational clinical trial was performed in ten children (C) and ten adults (A). Tracheas were intubated, in adults, with cuffed tubes and in children with uncuffed tubes. The operating room was equipped with modern air conditioning and waste anesthetic gas scavengers. Gas samples were obtained during the operative procedure every 90 sec from the breathing zone of subjects. Time-weighted averages (TWA) over the time of exposure were calculated for nitrous oxide and desflurane.
  
  
  RESULTS
  Nitrous oxide TWAs for anesthesiologists were 0.41 +/- 0.23 ppm (A) and 1.20 +/- 0.32 ppm (C, P < 0.0001), and 2.24 +/- 1.93 ppm (A) and 5.30 +/- 0.60 ppm (C, P = 0.0001) for the surgeon who worked close to the patient's airway and thus had higher exposure (P < 0.05 [A], P < 0.0001 [C]). With regard to desflurane, the anesthesiologists' TWAs were 0.02 +/- 0.03 ppm for both adults and children. The surgeon was exposed to 0.21 +/- 0.24 ppm desflurane (A) and 0.30 +/- 0.14 ppm (C, P: n.s.). Although the surgeon's exposure was greater (P < 0.05 [A], P < 0.0001 [C]), the threshold limits of 25 ppm for nitrous oxide and 2 ppm for desflurane recommended by the National Institute of Occupational Safety and Health were not exceeded.
  
  
  CONCLUSIONS
  Under modern air conditioning, occupational exposure to inhalational anesthetics is low, and inhalational anesthesia is safe from the standpoint of modern workplace laws and health-care regulations.
authors.affiliation: Department of Anesthesiology, Intensive Care Medicine, and Pain Control, J.W. Goethe-University Hospital Center, Frankfurt, Germany. c.byhahn@em.uni-frankfurt.de
authors.forename: C
authors.initials: C
authors.lastname: Byhahn
authors.forename: H J
authors.initials: HJ
authors.lastname: Wilke
authors.forename: U
authors.initials: U
authors.lastname: Strouhal
authors.forename: P
authors.initials: P
authors.lastname: Kessler
authors.forename: V
authors.initials: V
authors.lastname: Lischke
authors.forename: K
authors.initials: K
authors.lastname: Westphal
mesh_terms: D000328:Adult; D000397:Air Pollution; D000776:Anesthesiology; D018685:Anesthetics, Inhalation / Q000032:analysis*; D002648:Child; D000077335:Desflurane; D013502:General Surgery; D006801:Humans; D007530:Isoflurane / Q000031:analogs & derivatives* / Q000032:analysis; D009609:Nitrous Oxide / Q000032:analysis*; D016273:Occupational Exposure; D014068:Tonsillectomy
chemical_list: D018685:Anesthetics, Inhalation; D000077335:Desflurane; D007530:Isoflurane; D009609:Nitrous Oxide