TY - JOUR
T1 - Protossido d'azoto a basso tenore
T2 - Risk assessment e risk management
AU - Moscato, Umberto
AU - Pattavina, Fabio
AU - Zaffina, Salvatore
AU - Laurini, Carlo
AU - Camisa, Vincenzo
AU - Continolo, Nicola
AU - Sammartino, Marina
AU - Poscia, Andrea
AU - Colaiacomo, Gabriele
AU - Wachocka, Malgorzata
AU - La Milia, Daniele Ignazio
PY - 2016/7/1
Y1 - 2016/7/1
N2 - The administration of mixes with a low content of nitrous oxide (generally of 50% N2O in O2) is commonly used for pain management, inducing a light level of sedation, in endoscopy interventions, dentistry, particularly in the paediatric field, during childbirth sessions, etc⋯ Potential negative health effects associated with acute and hypothesized chronic workplace exposure not only limits it use in the operating room but causes several critical issues when used in environments that are not dedicated to operating activities and, consequently, do not come with sufficient air changes and appropriate anaesthetic gas scavenging systems. The aim was to assess occupational exposure of staff during mixes, with a low content of nitrous oxide, administration in patients undergoing digestive endoscopy procedure during use of a double face mask with a demand valve and a portable gas evacuation and dedicated system compared with a conventional single face mask without scavenging system. N2O concentrations, representing exposure values, were monitored within proximity to staff with a spectrophotometric acoustic multipoint system. The samples of 45 endoscopic procedures, taken at the breathing area zone of the staff, to more heights and in more sampling points of endoscopy environments analyzed, have detected a mean of 450±347 (standard deviation) ppm of nitrous oxide without scavenging system and a mean of 28±55ppm with double mask with a demand valve and portable gas evacuation system, significantly different values to the U Mann-Whitney test, with statistical significance p-value <0.001. In conclusion, the absence of specific regulatory limits for diagnostic and/or therapeutic procedures that use nitrous oxide in non-operating room environments, as well as the absence of rules or guidelines that indicate what systems of administration of anaesthetic gases should be used in those same environments, often not equipped with evacuation systems, require a prompt discussion of the scientific community of new rules on the use of mixtures with a low concentration of nitrous oxide.
AB - The administration of mixes with a low content of nitrous oxide (generally of 50% N2O in O2) is commonly used for pain management, inducing a light level of sedation, in endoscopy interventions, dentistry, particularly in the paediatric field, during childbirth sessions, etc⋯ Potential negative health effects associated with acute and hypothesized chronic workplace exposure not only limits it use in the operating room but causes several critical issues when used in environments that are not dedicated to operating activities and, consequently, do not come with sufficient air changes and appropriate anaesthetic gas scavenging systems. The aim was to assess occupational exposure of staff during mixes, with a low content of nitrous oxide, administration in patients undergoing digestive endoscopy procedure during use of a double face mask with a demand valve and a portable gas evacuation and dedicated system compared with a conventional single face mask without scavenging system. N2O concentrations, representing exposure values, were monitored within proximity to staff with a spectrophotometric acoustic multipoint system. The samples of 45 endoscopic procedures, taken at the breathing area zone of the staff, to more heights and in more sampling points of endoscopy environments analyzed, have detected a mean of 450±347 (standard deviation) ppm of nitrous oxide without scavenging system and a mean of 28±55ppm with double mask with a demand valve and portable gas evacuation system, significantly different values to the U Mann-Whitney test, with statistical significance p-value <0.001. In conclusion, the absence of specific regulatory limits for diagnostic and/or therapeutic procedures that use nitrous oxide in non-operating room environments, as well as the absence of rules or guidelines that indicate what systems of administration of anaesthetic gases should be used in those same environments, often not equipped with evacuation systems, require a prompt discussion of the scientific community of new rules on the use of mixtures with a low concentration of nitrous oxide.
KW - Endoscopy
KW - Guidelines
KW - Nitrous oxide
KW - Workplace exposure. standards
UR - http://www.scopus.com/inward/record.url?scp=84996844133&partnerID=8YFLogxK
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M3 - Articolo
AN - SCOPUS:84996844133
VL - 38
SP - 242
EP - 244
JO - Giornale Italiano di Medicina del Lavoro ed Ergonomia
JF - Giornale Italiano di Medicina del Lavoro ed Ergonomia
SN - 1592-7830
IS - 3
ER -