title: Waste gas exposure to sevoflurane and nitrous oxide during anaesthesia using the oesophageal-tracheal Combitube small adult.
abstract: Exposure to sevoflurane (SEV) and nitrous oxide during ventilation using a Combitube (37Fr) small adult (SA) was compared with waste gas exposure using conventional endotracheal tubes. Trace concentrations of SEV and nitrous oxide were assessed using a direct reading spectrometer during 40 gynaecological laparoscopic procedures under general anaesthesia. Measurements were made at the patients' mouth and in the anaesthetists' breathing zone. Mean (SD) concentrations of SEV and nitrous oxide measured at the patients' mouth were comparable in the Combitube SA (SEV 0.6 (0.2) p.p.m.; nitrous oxide 9.7 (8.5) p.p.m.) and endotracheal tube group (SEV 1.2 (0.8) p.p.m.; nitrous oxide 17.2 (10.6) p.p.m.). These values caused comparable contamination of the anaesthetists' breathing zone (SEV 0.6 (0.2) p.p.m. and nitrous oxide 4.3 (3.7) p.p.m. for the Combitube SA group, compared with SEV 0.5 (0.2) p.p.m. and nitrous oxide 4.1 (1.8) p.p.m. for the endotracheal tube group). We conclude that the use of the Combitube SA during positive pressure ventilation is not necessarily associated with increased waste gas exposure, especially when air conditioning and scavenging devices are available.
authors.affiliation: Department of Anaesthesiology and General Intensive Care, University of Vienna, Austria.
authors.forename: K H
authors.initials: KH
authors.lastname: Hoerauf
authors.forename: T
authors.initials: T
authors.lastname: Hartmann
authors.forename: S
authors.initials: S
authors.lastname: Acimovic
authors.forename: A
authors.initials: A
authors.lastname: Kopp
authors.forename: G
authors.initials: G
authors.lastname: Wiesner
authors.forename: B
authors.initials: B
authors.lastname: Gustorff
authors.forename: H
authors.initials: H
authors.lastname: Jellinek
authors.forename: P
authors.initials: P
authors.lastname: Krafft
mesh_terms: D000328:Adult; D000395:Air Pollutants, Occupational / Q000032:analysis*; D018685:Anesthetics, Inhalation / Q000032:analysis*; D005260:Female; D015920:Gas Scavengers; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D010535:Laparoscopy; D008738:Methyl Ethers / Q000032:analysis*; D009609:Nitrous Oxide / Q000032:analysis*; D016273:Occupational Exposure / Q000032:analysis*; D009873:Operating Rooms; D011175:Positive-Pressure Respiration; D000077149:Sevoflurane
chemical_list: D000395:Air Pollutants, Occupational; D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D009609:Nitrous Oxide