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LETTERS TO THE EDITOR

Operating Room Gas Contamination

Department of Anesthesiology, Duke University, Durham, NC Harvard Medical School, Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Department of Anesthesiology, Children’s Hospital, Boston, MA

To the Editor:

We very much appreciate Dr. Roth’s letter (1) regarding our study, our correspondence with Dr. Dunn (2,3), and our shared concern of making the workplace a safe environment for operating room staff. Dr. Roth’s suggestion of turning the fresh gas flows off as opposed to turning the vaporizer to the off position, in an effort to limit operating room contamination, may be much more widely practiced than Dr. Roth suggests. We have addressed this particular concept in our recent review of operating room scavenging (4) and suggest this as an additional, not alternative, strategy to reduce operating room contamination. Dr. Feldman investigated this particular practice recently (5) and found that the strategy of turning the fresh gas flow to a minimum while leaving the vaporizer at the set level (vol %) during the intubation procedure does not lead to contamination of the operating room with anesthetic gas. Further, leaving the vaporizer set at the desired induction vol % may actualy decrease induction time, because the gas concentration in the circuit remains high. This should facilitate induction when the circuit is then attached to the endotracheal tube just placed.

We join Dr. Roth in suggesting that anesthesia practitioners consider this technique as an additional method to reduce operating room contamination during the intubation process.

Acknowledgments

Dr. Roth does not wish to respond.

References

1. Roth JV. Another way to reduce operating room gas contamination [letter]. Anesth Analg. 2003; 97: 922.[Free Full Text]
2. Dunn SM. Reduction of operating room anesthetic gas contamination [letter]. Anesth Analg. 2003; 96: 910.[Free Full Text]
3. Panni MK, Corn SB. The use of a uniquely designed anesthetic scavenging hood to reduce operating room anesthetic gas contamination during general anesthesia. Anesth Analg. 2002; 95: 656–60.[Abstract/Free Full Text]
4. Panni MK, Corn SB. Scavenging in the operating room. Current Opinion in Anaesthesiology. In press.
5. Feldman JM. A simple strategy for faster induction and more cost-effective use of anesthetic vapor. J Clin Monit Comput 1999; 15: 17–21.[Medline]

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