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Sevoflurane is a widely used volatile agent for induction and maintenance of anaesthesia. The administration of sevoflurane involves the risk of occupational exposure. Possible negative implications of chronic occupational exposure to sevoflurane are not completely refuted. In Germany no maximum workplace concentration for sevoflurane is defined. This study aims to find out if working conditions of physicians and different anaesthesia techniques effect the extent of occupational exposure to sevoflurane.
In this prospective observational trial 7 cohorts of 4 participants each are investigated. The cohorts consist of physicians working at different places in the operating theatre with different occupational exposure to sevoflurane, and one cohort not working in the operating theatre at all. In order to determine the extent of occupational exposure to sevoflurane a human biomonitoring is conducted. Urinary Sevoflurane and its metabolite hexafluoroisopropanol (HFIP) are measured after 3 consecutive working days.
UPDATE: After detecting traces of HFIP in all cohorts even in physicians not working in the operating theatre measurements were repeated, more cohorts were added including a negative control and measurements before the study period of 3 consecutive working days were added.
UPDATE: For comparison one cohort of patients having undergone sevoflurane anaesthesia was added.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Anaesthesiologists balanced | Anaesthesiologists performing balanced anaesthesia with sevoflurane. |
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| Anaesthesiologists TIVA | Anaesthesiologists performing only total intravenous anaesthesia. |
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| Surgeons | Surgeons working in the operating room while anaesthesia of the patients is randomly maintained with sevoflurane or propofol. |
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| Anaesthesiologists PACU | Anaesthesiologists working in the postoperative care unit. |
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| Anaesthesiologists outside the operating room | Anaesthesiologists working outside of the operating room, for example pain service or anaesthesiological walk-in clinic |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| HFIP and Sevoflurane are measured after 3 consecutive days of work. | Diagnostic Test | Concentration of hexafluoroisopropanol and Sevoflurane are measured in urine by gas chromatography |
| Measure | Description | Time Frame |
|---|---|---|
| Urinary HFIP concentration (µg/l) | After 3 consecutive days of work a urine sample is collected and urinary HFIP is measured by gas chromatography | After 3 consecutive days of work |
| Urinary sevoflurane concentration (µg/l) | After 3 consecutive days of work a urine sample is collected and urinary sevoflurane is measured by gas chromatography | After 3 consecutive days of work |
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Inclusion Criteria:
Exclusion Criteria:
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Physicans with or without occupational exposure to sevoflurane.
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| Name | Affiliation | Role |
|---|---|---|
| Katharina Roeher, Dr. med | Universitätsklinikum Hamburg-Eppendorf | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Universitätsklinikum Hamburg-Eppendorf | Hamburg | 20246 | Germany |
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Urinary Samples
| Physicians not exposed |
Physicians not having contact with patients on wards/outpatient clinics after exposure with sevoflurane |
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| Patients | Patients having undergone sevoflurane anesthesia for elective surgery |
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