Comparison of waste anesthetic gases in operating rooms with or without an scavenging system in a Brazilian University Hospital

Braz, Leandro Gobbo; Braz, José Reinaldo Cerqueira; Cavalcante, Guilherme Aparecido Silva; Souza, Kátina Meneghetti; Lucio, Lorena Mendes de Carvalho; Braz, Mariana Gobbo

doi:10.1016/j.bjane.2017.04.008

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Scientific Articles • Rev. Bras. Anestesiol. 67 (5) • Sep-Oct 2017 • https://doi.org/10.1016/j.bjane.2017.04.008 copy

Comparison of waste anesthetic gases in operating rooms with or without an scavenging system in a Brazilian University Hospital

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Background and objectives

Occupational exposure to waste anesthetic gases in operating room without active scavenging system has been associated with adverse health effects. Thus, this study aimed to compare the trace concentrations of the inhalational anesthetics isoflurane and sevoflurane in operating room with and without central scavenging system.

Method

Waste concentrations of isoflurane and sevoflurane were measured by infrared analyzer at different locations (near the respiratory area of the assistant nurse and anesthesiologist and near the anesthesia station) and at two times (30 and 120 min after the start of surgery) in both operating room types.

Results

All isoflurane and sevoflurane concentrations in unscavenged operating room were higher than the US recommended limit (2 parts per million), regardless of the location and time evaluated. In scavenged operating room, the average concentrations of isoflurane were within the limit of exposure, except for the measurements near the anesthesia station, regardless of the measurement times. For sevoflurane, concentrations exceeded the limit value at all measurement locations and at both times.

Conclusions

The exposure to both anesthetics exceeded the international limit in unscavenged operating room. In scavenged operating room, the concentrations of sevoflurane, and to a lesser extent those of isoflurane, exceeded the recommended limit value. Thus, the operating room scavenging system analyzed in the present study decreased the anesthetic concentrations, although not to the internationally recommended values.

KEYWORDS
Inhaled anesthetics; Operating rooms; Indoor air pollution; Occupational exposure

Types of operating room	Inhaled anesthetics (ppm)	Measurement sites
		Nursing assistant		Anesthesiologist		Anesthesia workstation
		30 min	120 min	30 min	120 min	30 min	120 min
Without scavenging system	Iso	5.6 (1.8)	9.5 (3.4)^b b p < 0.01 compared with 30 min in the operating rooms without scavenging system, at all sites.	6.2 (2.0)	10.3 (3.4)^b b p < 0.01 compared with 30 min in the operating rooms without scavenging system, at all sites.	9.7 (6.5)	13.3 (6.4)^b b p < 0.01 compared with 30 min in the operating rooms without scavenging system, at all sites.
Without scavenging system	Sevo	7.5 (4.7)	16.1 (8.9)^b b p < 0.01 compared with 30 min in the operating rooms without scavenging system, at all sites.	8.5 (6.1)	16.7 (8.5)^b b p < 0.01 compared with 30 min in the operating rooms without scavenging system, at all sites.	14.1 (11.0)	20.0 (8.1)^b b p < 0.01 compared with 30 min in the operating rooms without scavenging system, at all sites.

With scavenging system	Iso	1.3 (0.9)^a a p < 0.001 compared with operating rooms without scavenging systems at all measurement sites at 30 min or 120 min.	1.1 (0.5)^a a p < 0.001 compared with operating rooms without scavenging systems at all measurement sites at 30 min or 120 min.	1.5 (1.1)^a a p < 0.001 compared with operating rooms without scavenging systems at all measurement sites at 30 min or 120 min.	1.2 (0.6)^a a p < 0.001 compared with operating rooms without scavenging systems at all measurement sites at 30 min or 120 min.	2.4 (1.0)^a a p < 0.001 compared with operating rooms without scavenging systems at all measurement sites at 30 min or 120 min.	3.6 (3.3)^a a p < 0.001 compared with operating rooms without scavenging systems at all measurement sites at 30 min or 120 min.
With scavenging system	Sevo	2.3 (1.1)^a a p < 0.001 compared with operating rooms without scavenging systems at all measurement sites at 30 min or 120 min.	2.9 (1.1)^a a p < 0.001 compared with operating rooms without scavenging systems at all measurement sites at 30 min or 120 min. ,^c c p = 0.02 compared with isoflurane at 120 min in the operating rooms with scavenging system.	2.6 (1.3)^a a p < 0.001 compared with operating rooms without scavenging systems at all measurement sites at 30 min or 120 min.	3.3 (1.9)^a a p < 0.001 compared with operating rooms without scavenging systems at all measurement sites at 30 min or 120 min. ,^c c p = 0.02 compared with isoflurane at 120 min in the operating rooms with scavenging system.	3.9 (2.9)^a a p < 0.001 compared with operating rooms without scavenging systems at all measurement sites at 30 min or 120 min.	4.8 (2.9)^a a p < 0.001 compared with operating rooms without scavenging systems at all measurement sites at 30 min or 120 min.

Sociedade Brasileira de Anestesiologia R. Professor Alfredo Gomes, 36, 22251-080 Botafogo RJ Brasil, Tel: +55 21 2537-8100, Fax: +55 21 2537-8188 - Campinas - SP - Brazil
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[1] * Corresponding author. E-mail:mgbraz@hotmail.com (M.G. Braz).