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TECHNOLOGY, COMPUTING, AND SIMULATION

Environmental Monitoring of Sevoflurane and Nitrous Oxide Using the Cuffed Oropharyngeal Airway

Burkhard Gustorff, MD DEAA^*, Norbert Lorenzl, MD^*, Laleh Aram, MD, Claus G. Krenn, MD, Brigitte P. Jobst, MD, and Klaus H. Hoerauf, MD

Departments of *Anesthesia and Intensive Care B and Anesthesia and Intensive Care A, Vienna General Hospital, University of Vienna, Austria

Address correspondence and reprint requests to Klaus H. Hoerauf, MD, Department of Anesthesiology and General Intensive Care, University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria. Address e-mail to klaus.hoerauf{at}univie.ac.at

We compared exposure to sevoflurane (SEV) and nitrous oxide (N₂O) during ventilation using the cuffed oropharyngeal airway (COPA) with waste gas exposure using a conventional face mask (FM) without any additional airways or face straps and with the laryngeal mask airway (LMA). Trace concentrations of SEV and N₂O were assessed by using a direct reading spectrometer during 33 surgical procedures under general anesthesia. Measurements were made at the patients’ mouths and in the anesthesiologists’ breathing zones. Mean ± SD concentrations of SEV and N₂O measured at the patients’ mouths were comparable in the COPA (SEV, 8.1 ± 12.2 ppm; N₂O, 213.3 ± 289.2 ppm) and LMA (SEV, 18.5 ± 25.8 ppm; N₂O, 283.4 ± 361.0 ppm) groups but differed significantly from the FM group (SEV, 46.5 ± 19.6 ppm; N₂O, 750.7 ± 308.3 ppm). These values resulted in a comparable contamination of the anesthesiologists’ breathing zones (SEV, 0.5 ± 0.2 ppm; N₂O, 5.7 ± 4.8 ppm) for the COPA group, compared with the LMA group (SEV, 1.0 ± 0.9 ppm; N₂O, 12.2 ± 14.3 ppm). This differed significantly from the FM group (SEV, 2.2 ± 0.9 ppm; N₂O, 37.5 ± 14.3 ppm). We conclude that the use of the COPA during short surgical interventions has an occupational safety comparable to that of the LMA and that both resulted in less contamination through waste anesthetic gases. Therefore, the COPA may be a valuable alternative to the conventional FM.

IMPLICATIONS: In this study, we have shown that the occupational exposure to waste anesthetic gases is comparable when using the cuffed oropharyngeal airway (COPA) and the laryngeal mask airway and is increased when using the face mask. Therefore, the COPA may be a valuable alternative to the conventional face mask during short surgical procedures.

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