The effect of local scavenging on occupational exposure to nitrous oxide

Despite evacuation of excess anaesthetic gases at the expiratory valve of the anaesthetic circuit and a general ventilation system producing 17-20 air changes per hour, mask anaesthesia often causes occupational exposure to anaesthetic gases exceeding the threshold limit values. The effect of a local air exhaust system, a local scavenger, on occupational exposure to nitrous oxide during paediatric mask anaesthesia was studied. The scavenger evacuated 140 m3 of air per hour and was placed at a distance of 20 cm from the face mask. In a very poorly ventilated operating theatre the exposure to nitrous oxide was reduced by 75% during the anaesthetic sessions and exposure to concentrations above 500 ppm was almost eliminated. The experiences from the installation and clinical use are discussed. Local scavenging is an excellent complement to the scavenging of excess gases at the expiratory valve, and it may be considered an alternative to expensive, high-capacity ventilation systems.