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GENERAL ARTICLES

Trace Nitrous Oxide Levels in the Postanesthesia Care Unit

Diana G. McGregor, MBBS, FRCA^*, David H. Senjem, BA, CSP, and Richard I. Mazze, MD

Departments of *Anesthesiology and Safety, Mayo Clinic, Rochester, Minnesota; and Department of Anesthesiology, Veterans Administration Palo Alto Health Care System and Stanford University, Stanford, California

Address correspondence and reprint requests to Diana G. McGregor, MBBS, FRCA, Department of Anesthesiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905. Address e-mail to dmcgregor{at}Mayo.edu

The effect of trace levels of waste anesthetic gases on the health of postanesthesia care unit (PACU) nurses who work in an unscavenged environment has been questioned, although it seems likely that levels of trace gases in the PACU would be much lower than those in the operating room. In this study, we documented nitrous oxide levels in the ambient air of two large PACUs. Nitrous oxide levels were measured using a time-weighted average monitor worn by 33 PACU workers at two different hospitals for the duration of their shifts. On the same day, patient data were collected at the time of admission to the PACU. Data included age and weight of the patient, type of surgery, anesthetic technique, and end-tidal level of nitrous oxide immediately before the patient left the operating room. The mean time-weighted average nitrous oxide level in PACU A was 2.0 ppm (range 0–6.4); in PACU B, it was undetectable, i.e., < 2.0 ppm. Levels of nitrous oxide to which PACU patient care personnel are exposed are well below the National Institute of Occupational Safety and Health and Occupational Health and Safety Administration recommended exposure level of 25 ppm measured for the duration of anesthetic administration.

Implications: Our results indicate that the levels of nitrous oxide in postanesthesia care units with well maintained, modern ventilation systems are very low. Previous research suggests that the health of workers exposed to these levels should not be adversely affected.

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Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999