SEDAZIONE COSCIENTE IN ENDOSCOPIA DIGESTIVA: L’IMPATTO AMBIENTALE ED IL RISCHIO DI ESPOSIZIONE DA MISCELA A BASSO TENORE DI PROTOSSIDO D’AZOTO

Translated title of the contribution: [Autom. eng. transl.] CONSCIOUS SEDATION IN DIGESTIVE ENDOSCOPY: THE ENVIRONMENTAL IMPACT AND THE RISK OF EXPOSURE FROM MIXTURE TO LOW CONTENT OF NITROXIDE

Gualtiero Ricciardi, Umberto Moscato, Daniele Ignazio La Milia, Andrea Poscia, Vincenzo Camisa, Nicola Continolo, Maria Sammartino Sinicalco, Lucio Petruzziello, Carlo Laurini, Malgorzata Wachocka, Salvatore Zaffina, G Colaiacomo, F Pattavina

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

[Autom. eng. transl.] INTRODUCTION: Exposure to anesthetic gases may represent one of the main risk factors of a chemical nature for medical personnel, as there is now extensive literature in relation to the onset, at high concentrations of exposure, of symptoms such as headache, neuro-behavioral alterations and performance modifications, while chronic low-dose exposure, the subject of numerous epidemiological studies, has been hypothesized to be predominantly a risk factor for spontaneous abortions and congenital malformations. To reduce the exposure risk to anesthetic gases it is necessary to guarantee an adequate number of air changes / hour thanks to the use of evacuator or scavenger systems. If these are provided for by the legislation and guidelines in the operating room, the same cannot be said for environments dedicated to performing diagnostic and therapeutic interventions in an outpatient setting (eg in digestive endoscopy, dentistry or in natural assisted delivery), for which, despite the increasing use of conscious sedation with Nitrous oxide (N2O) as an alternative to the intravenous route, a system suitable for the evacuation of gases is not expressly required / regulated. Although several studies have investigated the efficacy and clinical safety of N2O sedation patients during diagnostic-terpeutic procedures of digestive endoscopy, no study has significantly assessed the corresponding levels of environmental exposure for the staff who work there daily. In this regard, the aim of our study is to evaluate the N2O exposure of the personnel of digestive endoscopy clinics during analgo-sedation with 50% O2 / N2O mixture both in the presence and in the absence of a collection and evacuation system active of the N2O. MATERIALS AND METHODS: The study was carried out at the Surgical Digestive Endoscopy Unit of a University Hospital, during 45 diagnostic and / or therapeutic pancolonscopy procedures, in the period between February and May 2014. The interventions were divided into two groups : a first group (39 interventions) in which patients were sedated with a mixture of O2 / N2O delivered with the help of a dual-mask mobile evacuation system of the "NIKI 2002 Airnova" type; a second group (6 operations) in which patients were sedated with the same mixture of O2 / N2O, but without the aid of the mobile evacuation system. The environmental diffusion of O2 / N2O was evaluated through the continuous use, during the digestive endoscopy sessions, of a Bruel & Kjaer type photoacoustic infrared spectroscope “Multi-gas monitor model 1312” associated with a multi-sampler "1309" Bruel & Kjaer with "Innova 1312-7300" software, through five measurement points positioned inside the endoscopic surgery, with the probes placed in "area breathing zone" and at different heights. The results obtained were processed through descriptive statistical analysis using the "Stata IC 9.2 for Mac" software. The comparative analyzes of the point concentrations recorded in the two groups were carried out by the Mann-Whitney U test, considering a value of p≤0.05 as statistically significant. Data are reported as means ± standard deviation. RESULTS: The overall average of O2 / N2O concentrations detected in the 45 procedures was 145 ± 239 ppm, with significantly different trends in the two groups: in the group where the anesthetic gas capture and evacuation system was not used, the concentration mean of the N2O was 450 ± 347ppm, while in the group where the anesthetic gas capture and evacuation system was used the average concentration of N2O was 28 ± 55ppm. The values reported indicate significant d
Translated title of the contribution[Autom. eng. transl.] CONSCIOUS SEDATION IN DIGESTIVE ENDOSCOPY: THE ENVIRONMENTAL IMPACT AND THE RISK OF EXPOSURE FROM MIXTURE TO LOW CONTENT OF NITROXIDE
Original languageItalian
Title of host publicationATTI del 47° Congresso Nazionale SItI
Pages134-135
Number of pages2
Publication statusPublished - 2014
Event47° Congresso Nazionale SItI - Riccione
Duration: 1 Oct 20144 Oct 2014

Conference

Conference47° Congresso Nazionale SItI
CityRiccione
Period1/10/144/10/14

Keywords

  • esposizione ambientale
  • protossido d'azoto

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