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• W1517502589 abstract "Continuous end-tidal vapour monitoring may reduce the number of critical incidents associated with overdosage or underdelivery of volatile anaesthetics. Awareness resulting from under delivery remains relatively common, occurring in 0.1–0.2% of cases [1], although there are no comparative studies examining the effect of vapour analysers on its incidence [2]. In March 2007, the Association of Anaesthetists of Great Britain and Ireland (AAGBI) updated its guidelines to recommend vapour monitoring at all times during anaesthesia, including in the anaesthetic room [3]. To gauge the impact of these recommendations, we conducted a survey of current and intended future practice in hospitals across Scotland. After piloting the questionnaire for understanding and ease of completion, all major hospitals and most of the smaller hospitals providing anaesthetic services were surveyed by post. Non-responders were followed up by telephone. Of the 28 sites surveyed (257 anaesthetic rooms), replies were received from 27 (255 anaesthetic rooms). While vapour analysis is routinely available in theatre, it is present in just over half the anaesthetic rooms (n = 139, 55%). Full compliance with the guidelines was recorded at only 15 sites (56%), while at nine sites (33%), there was no vapour monitoring in any of the anaesthetic rooms. Three sites (16 anaesthetic rooms) planned to obtain vapour monitors in the short-term, another three sites (33 rooms) reported that they would be unable to purchase monitors within 12 months, and the remaining six sites (67 rooms) were unsure, stating that they were in the process of assessing the financial implications of meeting the standards. Upgrading existing equipment has a lower initial cost than replacement, but the resources required for anaesthetic directorates to meet the recommendations may, nevertheless, be considerable. Of course, the recommendations can also be met by inducing patients in theatre rather than in the anaesthetic room. None of the non-compliant hospitals expressed an intention to do this; the reasons were not identifiable from the questionnaire. This survey demonstrates that almost half of Scottish anaesthetic departments do not comply with the recommendations of the AAGBI, and that full compliance is unlikely in the near future. Where budgetary constraints preclude the early purchase of vapour analysers, anaesthetic directorates face a dilemma: comply with the guidelines immediately by abandoning the anaesthetic room and anaesthetising patients in theatre, or defer adoption and continue to use the anaesthetic room to preserve theatre throughput efficiencies. These data were also presented, in part, at the ‘Advances in Anaesthesia and Intensive Care’ meeting, Glasgow, September 2007." @default.
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• W1517502589 date "2008-02-15" @default.
• W1517502589 modified "2023-10-18" @default.
• W1517502589 title "Vapour monitoring in the anaesthetic room in Scotland" @default.
• W1517502589 cites W2115540578 @default.
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• W1517502589 doi "https://doi.org/10.1111/j.1365-2044.2008.05470.x" @default.
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