Features  |   November 2013
Anesthetic Scavenging Outside the O.R.
Author Affiliations
  • James Michael Berry, M.D.
    Committee on Equipment and Facilities
Article Information
Pharmacology / Technology / Equipment / Monitoring / Features
Features   |   November 2013
Anesthetic Scavenging Outside the O.R.
ASA Monitor 11 2013, Vol.77, 18-19.
ASA Monitor 11 2013, Vol.77, 18-19.
As demand for anesthesia services outside the traditional O.R. environment continues to grow, the technical and logistic challenges of providing anesthesia multiply. Anesthesia providers are concerned about the space, equipment and support requirements for safe anesthesia, while proceduralists demand a full range of anesthesia services in a closet-sized space.
One of the common concerns is the need for adequate waste anesthetic scavenging in “off-site” locations. These may be small, minimally-equipped procedure or treatment rooms lacking wall oxygen, nitrous oxide or even vacuum sources. Scavenging in this situation may be difficult or impossible. What is an appropriate solution?
The history of waste anesthetic scavenging dates to the 1970s. In the late 1960s it was observed that chronic exposure to anesthetic waste gases might have negative health effects on perioperative staff, specifically an increased incidence of miscarriage in O.R. personnel.1  Multiple studies failed to find a consistent association between exposure to waste anesthetic gases and adverse health outcomes. Nonetheless, this concern led to the 1977 recommendation by the National Institute of Occupational Safety & Health (NIOSH) that anesthetic concentrations in the O.R. environment be limited. Until this time, the “exhaust” from anesthesia machines was vented into the O.R. environment with little concern. The use of higher fresh gas flows and semi-open circuits at the time also contributed to the O.R. pollution.
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