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TECHNOLOGY, COMPUTING, AND SIMULATION

Sevoflurane in Exhaled Air of Operating Room Personnel

G. Summer, MD^*, P. Lirk, MD^*, K. Hoerauf, MD, U. Riccabona, MD^*, F. Bodrogi, MB^*, H. Raifer, BSc^*, M. Deibl, BSc, J. Rieder, MD^*, and W. Schobersberger, MD^*

*Department of Anesthesiology and Critical Care Medicine and Department of Medical Biostatistics, University of Innsbruck; and Department of Anesthesiology and General Intensive Care, University of Vienna, Austria

Address correspondence and reprint requests to Wolfgang Schobersberger, MD, Department of Anesthesiology and Critical Care Medicine, Anichstr. 35, 6020 Innsbruck, Austria. Address e-mail to Wolfgang.Schobersberger{at}uibk.ac.at

Evidence on potential health hazards arising from exposure to volatile anesthetics remains controversial. Exposure may, in principle, be supervised by monitoring of ambient air or, alternatively, in vivo. We used the Proton Transfer Reaction-Mass Spectrometry to screen the breath of 40 operating room staff members before operating room duty, 0, 1, 2, and 3 h after duty, and before commencing duty on the consecutive day, and control persons. Staff members exhibited significantly increased sevoflurane levels in exhaled air after duty, with a mean of 0.80 parts per billion as compared with baseline values of 0.26 parts per billion (P < 0.05). Analysis of variance with adjustment for within correlation (repeated measurements) showed a statistically significant time-effect (P < 0.001). We conclude that (a) Proton Transfer Reaction-Mass Spectrometry biomonitoring of exhaled sevoflurane can serve as a simple and rapid method to determine volatile anesthetic excretion after occupational exposure, and (b) significant concentrations of sevoflurane may be continuously present in persons exposed to sevoflurane on a daily basis.

IMPLICATIONS: The present study depicts the profile of volatile anesthetics, isoflurane and sevoflurane, in exhaled air of ambulatory patients. Biomonitoring of expired anesthetic concentrations is a noninvasive and rapid method to determine volatile anesthetic excretion.