Second-hand exposure to aerosolized intravenous anesthetics propofol and fentanyl may cause sensitization and subsequent opiate addiction among anesthesiologists and surgeons
Second-hand exposure to aerosolized intravenous anesthetics propofol and fentanyl may cause sensitization and subsequent opiate addiction among anesthesiologists and surgeons
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DOI：
10.1016/j.mehy.2005.10.030
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发表时间：
2006-01-01
影响因子：
4.7
通讯作者：
Cendán, JC
中科院分区：
文献类型：
--
作者：
McAuliffe, PF;Gold, MS;Cendán, JC
我们假设，手术室内患者静脉注射麻醉剂的雾化可能是医生的非预期暴露源。这可能会导致无意中的致敏，这与发展成成瘾的风险增加有关。这可能有助于某些专业的过度代表性的医生与addictions.We回顾性地审查了所有持牌医师治疗药物滥用的人口统计信息，自1980年以来，在佛罗里达州，以确定是否医疗专业与成瘾在这组人。然后，为了确定潜在的暴露，两个质谱分析被开发来检测两种静脉给药的药物，芬太尼和丙泊酚，在air.Since 1980，7.6%的持牌佛罗里达医生接受成瘾治疗。麻醉师的成瘾率高于预期。与其他专业相比，麻醉师和外科医生的阿片类药物滥用更严重。在心胸手术室的空气中，在患者的呼气回路中，以及在锐器盒上方的顶部空间中检测到雾化芬太尼，但在相邻的走廊中没有检测到。在一位接受经尿道前列腺切除术的病人的麻醉中发现了雾化的异丙酚，虽然麻醉师和外科医生的麻醉和压力可能会使他们面临更大的药物滥用风险，但另一个风险因素可能是无意中职业性暴露于成瘾药物。本报告提供了使用两种新开发的分析方法检测雾化静脉麻醉药的初步证据。我们的结论是，长期暴露于低水平的空气中静脉注射药物的可能性存在。目前正在进行进一步的研究，以确定这种接触的重要性。(c)2005爱思唯尔有限公司保留所有权利。
We hypothesize that aerosolization of anesthetics administered intravenously to patients in the operating room may be an unintended source of exposure to physicians. This may lead to inadvertent sensitization, which is associated with an increased risk for developing addiction. This may contribute to the over-representation of certain specialties among physicians with addiction.We retrospectively reviewed the de-identified demographic information of all licensed physicians treated for substance abuse in the State of Florida since 1980, to determine if medical specialty was associated with addiction in this group of individuals. Then, to identify the potential for exposure, two mass spectrometry assays were developed to detect two intravenously administered drugs, fentanyl and propofol, in air.Since 1980, 7.6% of licensed Florida physicians underwent treatment for addiction. Addiction in anesthesiologists was higher than expected. Opiate abuse was greater in anesthesiologists and surgeons compared to other specialties. Aerosolized fentanyl was detected in the air of the cardiothoracic operating room, in patients' expiratory circuits, and in the headspace above sharps boxes, but not in adjoining hallways. Aerosolized propofol was detected in the expirations of a patient undergoing transurethral prostatectomy.While access and stress may place anesthesiologists and surgeons at greater risk for substance abuse, an additional risk factor may be unintended occupational exposure to addictive drugs. This report provides preliminary evidence of detection of aerosolized intravenous anesthetics using two newly developed analytical methods. We conclude that the potential exists for chronic exposure to low levels of airborne intravenously administered drugs. Further studies are under way to determine the significance of this exposure. (c) 2005 Elsevier Ltd. All rights reserved.