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A newly developed scavenging system for administration of nitrous oxide during labour: safe occupational use
Author(s) -
KOOY J.,
GRAAF J. P.,
KOLDER Z. M.,
WITTERS K. D.,
FITZPATRICK E.,
DUVEKOT J. J.,
DONSSINKE I. J. J.,
STEEGERS E. A. P.,
BONSEL G. J.
Publication year - 2012
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.2012.02668.x
Subject(s) - medicine , nitrous oxide , scavenging , occupational exposure , occupational medicine , anesthesia , surgery , toxicology , environmental health , antioxidant , biochemistry , chemistry , biology
Objective Nitrous oxide ( N 2 O ) is routinely used as an analgesic in obstetrics during labour. Epidemiological studies have linked chronic occupational exposure to N 2 O to specific health problems, including reproductive risks. Occupational exposure limits ( OELs ) allow the use of N 2 O once appropriate preventive and safety measures have been taken. We assessed the effectiveness of a scavenger system ( A nevac P ‐system®, M edicvent H einen & L öwestein B enelux, B arneveld, the N etherlands) applied in N 2 O administration during labour in a midwifery‐led birthing centre in the N etherlands. Methods After informed consent, non‐pregnant midwives were trained to administer N 2 O . N 2 O was delivered as a 50 : 50 mixture with oxygen and was self administered by the patient. The scavenging device, containing a double mask and a chin mask, was connected to the local evacuation system vented outside the building. Data on the 8‐h time‐weighted average (8‐h TWA ) as well as the 15‐min TWA (15‐min TWA ) were obtained. Results Thirteen patients were included. Six patients were included in the first study period. In this period the 8‐h TWA was not exceeded, however, in all patients, the 15‐min TWA occasionally exceeded the OELs . After four additional measures, seven patients were included. After implementation of these measures, the 8‐h TWA and 15‐min TWA never exceeded the OELs . System leakage was not observed during both study periods. Conclusion The Anevac P ‐scavenging system during N 2 O analgesia in labour prevents exceeding OELs in professional workers. The scavenging system appeared acceptable and effective, and can be considered in hospital settings that use N 2 O as analgesic during labour.