Surgeons' exposure to sevoflurane during paediatric adenoidectomy: a comparison of three airway devices

• Published in: Anaesthesia Vol. 71; no. 8; pp. 915 - 920
• Main Authors: Herzog‐Niescery, J., Gude, P., Gahlen, F., Seipp, H.‐M., Bartz, H., Botteck, N. M., Bellgardt, M., Dazert, S., Weber, T. P., Vogelsang, H.
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.08.2016
• Subjects: Airway management; Anesthesia; inhaled anaesthetic: sevoflurane; occupational sevoflurane exposure; paediatrics: airway management adenoidectomy; Pediatrics; photo‐acoustic gas monitor; surgeon: anaesthetic gas exposure; inhaled anaesthetic: sevoflurane; photo-acoustic gas monitor; paediatrics: airway management adenoidectomy; surgeon: anaesthetic gas exposure; occupational sevoflurane exposure
• ISSN: 0003-2409; 1365-2044
• DOI: 10.1111/anae.13515

Summary Although sevoflurane is commonly used in anaesthesia, a threshold value for maximum exposure to personnel does not exist and although anaesthetists are aware of the problem, surgeons rarely focus on it. We used a photo‐acoustic infrared device to measure the exposure of surgeons to sevoflurane during paediatric adenoidectomies. Sixty children were randomly allocated to laryngeal mask, cuffed tracheal tube or uncuffed tracheal tube. The average mean (maximum) sevoflurane concentrations within the surgeons' operating area were 1.05 (10.05) ppm in the laryngeal mask group, 0.33 (1.44) ppm in the cuffed tracheal tube group and 1.79 (18.02) ppm in the uncuffed tracheal tube group, (p < 0.001), laryngeal mask and cuffed tracheal tube groups vs. uncuffed tube group. The presence of sevoflurane was noticed by surgeons in 20% of cases but there were no differences between the groups (p = 0.193). Surgical and anaesthetic complications were similar in all three groups. We conclude that sevoflurane can be safely used during adenoidectomies with all three airway devices, but in order to minimise sevoflurane peak concentrations, cuffed tracheal tubes are preferred.