查詢結果分析
來源資料
相關文獻
- Personnel Exposure to Waste Sevoflurane and Nitrous Oxide during General Anesthesia with Cuffed Endotracheal Tube
- Nitro変-L-Arginine Methyl Ester Decreases Minimum Alveolar Concentration of Isoflurane and Reduces Brain Nitric Oxide Synthase Activity in Rats
- 應用霍式紅外光譜法調查半導體廠製程危害性氣體
- 護理人員在職業場所中暴露於HIV感染源時的處理
- 心臟手術麻醉用藥: 比較類鴉片藥物與吸入性麻醉劑
- 暴露勞工世代研究資料庫之建立--過去世代資料管理與追蹤模式建立
- Premedication with Low-dose Oral Midazolam Reduces the Incidence and Severity of Emergence Agitation in Pediatric Patients Following Sevoflurane Anesthesia
- 淺談職業暴露評估與管理
- Comparison of Inhalation Induction with 2%,4%,6%, and 8% Sevoflurane in Nitrous Oxide for Pediatric Patients
- 職業暴露於極低頻電場與磁場之危害與防護
頁籤選單縮合
題名 | Personnel Exposure to Waste Sevoflurane and Nitrous Oxide during General Anesthesia with Cuffed Endotracheal Tube=手術房麻醉人員之麻醉廢氣暴露濃度評估 |
---|---|
作者 | 李壽煌; 李壽南; 施惠雅; 易煥德; 江錦源; | 書刊名 | 麻醉學雜誌 |
卷期 | 40:4 2002.12[民91.12] |
頁次 | 頁185-190 |
分類號 | 416.5 |
關鍵詞 | 吸入性麻醉劑; 職業暴露; 霍氏紅外光譜儀; Anesthetics; Inhalation; Occupational exposure; Spectroscopy; Fourier transform infrared; |
語文 | 英文(English) |
中文摘要 | 背景:根據相關研究報告顯示中,麻醉廢氣可能危害手術房麻醉人員的健康,爲降低麻醉廢氣造成的健康風險,美國職業安全衛生研究所(US-NIOSH)對常用的麻醉氣體其暴露容許濃度,其中N2O的平均容許濃度爲25ppm,而其他揮發性麻醉劑(如sevoflurane, isoflurane, desflurane, enflurane and halothane)建議最高容許濃度爲2ppm。方法:爲評估國內麻醉人員對麻醉廢氣的暴露狀況,本研究使用抽氣式霍氏紅外光譜儀(extractive FTIR)量測麻醉人員於手術過程中麻醉廢氣的暴露情形;本研究中,麻醉過程對病人的誘導採靜脈注射,而麻醉維持則具有袖帶之氣管內管(cuffed endotracheal tube)將11/min的N2O、11/min的O2和2.5%的sevoflurane (SEV)導進病人的呼吸系統。結果:在正常的麻醉過程,麻醉人員對N2O的平均暴露濃度爲31.5ppm,而對SEV最高暴露濃度值僅爲1.45ppm;然而,在催醒前麻醉機器管路的迫淨,造成N2O與SEV的暴露濃度分別提高至751ppm與26ppm。另外,氣管內管袖帶之不完全充氣、麻醉機器廢氣管路與醫院排氣系統間的接頭脫落,皆造成麻醉廢氣濃度的嚴重昇高。結論:爲避免N2O的健康危害,在麻醉過程中應盡量減少其使用;同時,(1)麻醉機器管路的迫淨、(2)氣管內管袖帶之不完全充氣與(3)麻醉機器廢氣管路與醫院排氣系統間的接頭脫落等三種不當操作應避免發生,以維護手術房內人員的健康。 |
英文摘要 | Background: Waste anesthetic gases may have adverse effects on the health of operating room personnel. To reduce the risk of exposure, the United States National Institute of Occupational Safety and Health (US-NIOSH) recommends a time-weighted average (TWA) of 25 ppm (part-per-million) for nitrous oxide N2O) and a ceiling of 2 ppm for sevoflurane (SEV). This study investigated the concentrations of these two gases in the atmosphere of operating room to which the working personnel (anesthetists) were exposed during anesthetic practice. Methods: An extractive Fourier transform infrared (FHR) spectrometer with an optical path length of 10 meters, was used to monitor the concentrations of waste general anesthetics in the operating rooms. The FTIR in application could simultaneously determine the concentrations of several gases in a near real-time manner, which helped to accurately obtain the varying concentrations of gases in different anesthetic condition. The sampling Teflon tube of the FTIR was conveniently installed in the breathing zone of the anesthetic personnel to obtain the personal exposure concentrations of N20 and SEV. Results: Nitrous oxide (N2O) and sevoflurane (SEV) concentrations for five surgeries in four different operating rooms were determined. In normal condition during maintenance, the SEV concentrations as measured were less than 2 ppm but the average N20 concentration was greater than 25 ppm. In addition, in three abnormal or specific conditions, the N20 and SEV concentrations increased dramatically. Firstly, at the end of maintenance (tight before emergence), peak concentrations of 751 ppm for N20 and 26 ppm for SEV were measured. These unusually high concentrations resulted from flushing the tubing of the anesthetic machine to speed up theemergenceof wakefulness of the patient from anesthesia. Secondly, when the cuff of the endotracheal tube was not well inflated or unserviceable, peak concentrations of 631 ppm for N20 and 32 ppm for SEV were measured. Thirdly, malfunction of or loose connection (or disconnection) between the anesthetic machine and the exhaust venting system of operating theater almost doubled the N20 and SEV concentrations. Conclusions: To decrease the exposure of the operating personnel to waste anesthetics, minimization of the use of N20 is recommended. Besides, the three extraordinary conditions as disclosed in this study were tubing flushing, illy managed endotracheal tube cuff and disconnection of scarvenging system, the first of which sometimes is unavoidable but the last two of which should be avoided. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。