醫療院所麻醉用氣體採樣分析技術研究

Development and Evaluation of Measurement Methods for Anesthetic Gases in Medical Units

王守堅(Shou-Chien Wang) ； 林威龍(Wei-Lung Lin) ； 鄭淑芳(Shu-Fang Cheng) ； 廖祐伶(Yu-Ling Liao) ； 陳叡瑜(Ruey-Yu Chen)

《勞工安全衛生研究季刊》 15卷1期 (2007/03) Pp. 67-79

https://doi.org/10.7005/JOSH.200703.0067

摘要

醫療院所醫護人員在使用麻醉氣體為病患進行手術時，常暴露於病患呼出或管線洩漏之麻醉廢氣，其中以笑氣最為嚴重。研究指出，暴露笑氣可能會造成醫護人員生殖系統之危害，引發自發性流產、早產、新生兒低出生體重以及不孕等問題，並可能會減緩心智活動之能力，實有必要對醫療院所麻醉廢氣定期進行環境監測。
然而，我國尚未建立麻醉廢氣之職業暴露標準以及採樣分析建議方法，因此本研究建立以採樣袋收集笑氣和三種常用鹵素麻醉劑（Desflurane、Sevoflurane及Isoflurane）揮發氣體樣本，再利用氣相層析質譜儀(GC-MS)進行濃度分析的採樣分析方法，並驗證方法之準確性與精確性。實驗結果顯示，使用此方法同時偵測笑氣及前述三種鹵素麻醉劑，具良好之定性及定量能力，笑氣檢量線線性範圍為5~200ppm，鹵素麻醉劑約為0.2~2ppm，笑氣、Desflurane、Sevoflurane及Isoflurane之偵測極限分別是1.37ppm、0.03ppm、0.02ppm和0.02ppm，採樣後在冷藏之環境下可以儲存七天以上，而使用內標法則可增加分析的穩定性及準確度。故本研究方法值得做為麻醉廢氣分析方法選擇之參考。

關鍵字

笑氣 ； 鹵素麻醉劑 ； 麻醉廢氣 ； 採樣分析方法

並列摘要

Nitrous oxide, the so-called laughing gas, and halogenated agents are commonly used as surgical inhalation anesthetics. Health care professionals who work in operating rooms or recovery rooms are potentially exposed to escaped anesthetic gases, especially nitrous oxide, from various components of the anesthesia delivery system or the exhaled gases of patients. The possible health effects of nitrous oxide exposure include spontaneous abortion, premature delivery, low birth weight, and involuntary infertility, as well as a decline in audiovisual performance. It is important to evaluate the potential risks of excessive exposure to anesthetic gases and to implement appropriate controls to minimize the risks.
At present, the Council of Labor Affairs has no established permissible exposure limits or standard analytical methods for these agents. In this study, a new measurement method is developed for nitrous oxide and three common halogenated anesthetic gases, desflurane, sevoflurane and isoflurane. Air samples are taken and analyzed to determine their concentrations using gas chromatography with mass detector. Field test results show that anesthetic gases can be measured in one analytical procedure with good precision and accuracy. The Calibration curve range for nitrous oxide is 0.5 to 200 ppm, and the range for halogenated anesthetics is about 0.2 to 2 ppm. Detection limits for nitrous oxide, desflurane, sevoflurane and isoflurane are 1.37, 0.03, 0.02 and 0.02 ppm, respectively. After sampling, samples can be stored at least a week below 4℃ with acceptable accuracy. Analysis precision and accuracy can be improved by adding internal standards. This method is an excellent alternative for escaped anesthetic gases sampling and analysis.

並列關鍵字

Nitrous oxide ； Halogenated anesthetic agents ； Waste anesthetic gases ； Sampling and analytical method

參考文獻

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