Health worker exposure risk during inhalation sedation with sevoflurane using the (AnaConDa®) anaesthetic conserving device

Rodríguez, Ramón; Martinez, Allison; Serrano, Javier García; García, M.V. Moral

doi:10.1016/j.redar.2013.11.011

Cited by 25 publications

(11 citation statements)

References 25 publications

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“…Another potential risk factor is the use of inhalational sedation devices postoperatively in the intensive care unit (ICU) for a range of different conditions [ 25 – 28 ]. Patients susceptible to MH also resident in the ICU may be at risk from such exposure, although administration of sevoflurane via the AnaConDa® device was found to be safe for healthcare workers with the caveat that a gas extraction system should be used in conjunction with such devices to reduce occupational exposure [ 29 ]. A case of MH triggered by sevoflurane administration via an AnaConDa® was reported in a patient admitted to ICU for lumbalgia.…”

Section: Reviewmentioning

confidence: 99%

Malignant hyperthermia: a review

Rosenberg

Pollock

Schiemann

et al. 2015

Orphanet J Rare Dis

449

529

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Malignant hyperthermia (MH) is a pharmacogenetic disorder of skeletal muscle that presents as a hypermetabolic response to potent volatile anesthetic gases such as halothane, sevoflurane, desflurane, isoflurane and the depolarizing muscle relaxant succinylcholine, and rarely, in humans, to stressors such as vigorous exercise and heat. The incidence of MH reactions ranges from 1:10,000 to 1: 250,000 anesthetics. However, the prevalence of the genetic abnormalities may be as great as one in 400 individuals. MH affects humans, certain pig breeds, dogs and horses. The classic signs of MH include hyperthermia, tachycardia, tachypnea, increased carbon dioxide production, increased oxygen consumption, acidosis, hyperkalaemia, muscle rigidity, and rhabdomyolysis, all related to a hypermetabolic response. The syndrome is likely to be fatal if untreated. An increase in end-tidal carbon dioxide despite increased minute ventilation provides an early diagnostic clue. In humans the syndrome is inherited in an autosomal dominant pattern, while in pigs it is autosomal recessive. Uncontrolled rise of myoplasmic calcium, which activates biochemical processes related to muscle activation leads to the pathophysiologic changes. In most cases, the syndrome is caused by a defect in the ryanodine receptor. Over 400 variants have been identified in the RYR1 gene located on chromosome 19q13.1, and at least 34 are causal for MH. Less than 1 % of variants have been found in CACNA1S but not all of these are causal. Diagnostic testing involves the in vitro contracture response of biopsied muscle to halothane, caffeine, and in some centres ryanodine and 4-chloro-m-cresol. Elucidation of the genetic changes has led to the introduction of DNA testing for susceptibility to MH. Dantrolene sodium is a specific antagonist and should be available wherever general anesthesia is administered. Increased understanding of the clinical manifestation and pathophysiology of the syndrome, has lead to the mortality decreasing from 80 % thirty years ago to <5 % in 2006.

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Section: Reviewmentioning

confidence: 99%

Malignant hyperthermia: a review

Rosenberg

Pollock

Schiemann

et al. 2015

Orphanet J Rare Dis

449

529

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“…Air pollution was first described by Sackey and colleagues in 2004, who reported mean ISO concentrations of approximately 0.1 ppm in patient rooms and peaks of up to 11 ppm during replacement of the AnaConDa™ filter . Subsequent studies found that waste VA concentrations were slightly higher (0.3‐2.0 ppm) in patient rooms and personnel's breathing zones, whereas the highest peaks (20‐50 ppm) were detected close to the expiratory port of the ventilator …”

Section: Discussionmentioning

confidence: 98%

Environmental safety: Air pollution while using MIRUS™ for short‐term sedation in the ICU

Herzog-Niescery

Vogelsang

Gude

et al. 2018

Acta Anaesthesiol Scand

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“…Technologies are currently being developed and refined to capture and destroy scavenged agents, thereby further reducing their atmospheric release [36]. The possibility of rescuing them again is also actually being considered, extracting them from these carbon filters where they remain trapped, in order to be reused, achieving recycling in the form of a circular economy (CONTRAfluran TM ) [37]. Furthermore, we should always consider to use low oxygen/air flows, appropriate for the delivery system used [38].…”

Section: Discussionmentioning

confidence: 99%

Postanesthetic Emergence Delirium in Children: Qualitative Differences between Sevoflurane vs Desflurane: A Randomized Clinical Trial

Dueñas¹,

Carretero²,

Reinoso-Barbero³

et al. 2022

OJAnes

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Background: Emergence Delirium (ED) is considered a usual complication in pediatric anesthesia. Aim: Analyze the quantitative and qualitative differences in ED in children receiving general anesthesia with sevoflurane or desflurane in day case surgery. Materials and Methods: Two hundred and two children, ASA I-II, who required outpatient elective day case surgery, were assigned to receive anesthesia with sevoflurane or desflurane. ED was assessed by a masked investigator using the Pediatric Anesthesia Emergence Delirium (PAED) scale at 5 and 15 minutes (min). Results: Mean time to wake up was shorter with desflurane compared with sevoflurane (6.0 versus 8.3 min, p = 0.0001).

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Health worker exposure risk during inhalation sedation with sevoflurane using the (AnaConDa®) anaesthetic conserving device

Cited by 25 publications

References 25 publications

Malignant hyperthermia: a review

Malignant hyperthermia: a review

Environmental safety: Air pollution while using MIRUS™ for short‐term sedation in the ICU

Postanesthetic Emergence Delirium in Children: Qualitative Differences between Sevoflurane vs Desflurane: A Randomized Clinical Trial

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