Waste gas exposure to sevoflurane and nitrous oxide during anaesthesia using the oesophageal–tracheal Combitube small adultTM

• Published in: British journal of anaesthesia : BJA Vol. 86; no. 1; pp. 124 - 126
• Main Authors: Hoerauf, K.H., Hartmann, T., Acimovic, S., Kopp, A., Wiesner, G., Gustorff, B., Jellinek, H., Krafft, P.
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01.01.2001; Oxford University Press
• Subjects: anaesthetics gases, trace concentrations; anaesthetics volatile, trace concentrations; equipment, tracheal tube; anaesthetics volatile, trace concentrations; equipment, tracheal tube; anaesthetics gases, trace concentrations; anaesthetics volatile, trace concentrations; anaesthetics gases, trace concentrations; equipment, tracheal tube
• ISSN: 0007-0912; 1471-6771
• DOI: 10.1093/bja/86.1.124

Exposure to sevoflurane (SEV) and nitrous oxide during ventilation using a Combitube (37Fr) small adult (SA)™ was compared with waste gas exposure using conventional endotracheal tubes. Trace concentrations of SEV and nitrous oxide were assessed using a direct reading spectrometer during 40 gynaecological laparoscopic procedures under general anaesthesia. Measurements were made at the patients’ mouth and in the anaesthetists’ breathing zone. Mean (sd) concentrations of SEV and nitrous oxide measured at the patients’ mouth were comparable in the Combitube SA™ (SEV 0.6 (0.2) p.p.m.; nitrous oxide 9.7 (8.5) p.p.m.) and endotracheal tube group (SEV 1.2 (0.8) p.p.m.; nitrous oxide 17.2 (10.6) p.p.m.). These values caused comparable contamination of the anaesthetists’ breathing zone (SEV 0.6 (0.2) p.p.m. and nitrous oxide 4.3 (3.7) p.p.m. for the Combitube SA™ group, compared with SEV 0.5 (0.2) p.p.m. and nitrous oxide 4.1 (1.8) p.p.m. for the endotracheal tube group). We conclude that the use of the Combitube SA™ during positive pressure ventilation is not necessarily associated with increased waste gas exposure, especially when air conditioning and scavenging devices are available.