Long‐duration, Low‐flow Sevoflurane Anesthesia Using Two Carbon Dioxide Absorbents: Quantification of Degradation Products in the Circuit
Long‐duration, Low‐flow Sevoflurane Anesthesia Using Two Carbon Dioxide Absorbents: Quantification of Degradation Products in the Circuit
复制标题
使用两种二氧化碳吸收剂的长持续时间、低流量七氟烷麻醉：回路中降解产物的定量
DOI：
10.1097/00000542-199408000-00011
复制
发表时间：
1994
期刊：
影响因子：
8.8
通讯作者：
K. Ikeda
中科院分区：
文献类型：
--
作者：
H. Bito;K. Ikeda
背景七氟醚与纯碱石灰反应，产生降解产物。低流量循环中七氟醚降解产物的浓度在麻醉时间小于5h时已有报道。在本研究中，检测了低流量麻醉超过10h时产生的七氟醚降解产物。方法16例患者采用七氟醚麻醉，新鲜气流量为11次/min。在8名患者中，使用了苏打石灰作为二氧化碳吸收剂；在另外8名患者中，使用了Baralyme。在麻醉过程中，测量循环中降解产物的浓度、二氧化碳吸收剂的温度、吸入和呼气末七氟醚的浓度以及患者排出的二氧化碳体积。从电路的吸气肢体采集气体，并用气相色谱进行分析。结果检测到两种降解产物CF2=C(CF3)-O-CH2F(化合物A)和CH3OCF2CH(CF3)OCH2F(化合物B)。在纯碱石灰组中，化合物A的个体最大浓度为23.6±2.9(12.0-37.4)ppm。Baralyme组的浓度为32.0±2.3(23.5-41.3)ppm。Baralyme组中化合物A的个体最大浓度显著高于纯碱石灰组。在两名患者中检测到化合物B，最高浓度为0.2ppm。两组患者的七氟醚呼气末浓度、二氧化碳吸收剂温度和患者排出的二氧化碳体积相同。结论在长时间、低流量七氟醚麻醉中，可检测到低浓度的降解产物。Baralyme产生的降解产物浓度高于苏打石灰。
BackgroundSevoflurane reacts with soda lime, generating degradation products. The concentrations of sevoflurane degradation products in a low-flow circuit have been reported for anesthesia times of less than 5 h. In this study, sevoflurane degradation products generated during low-flow anesthesia exceeding 10 h were examined. MethodsSixteen patients received sevoflurane anesthesia with a fresh gas flow rate of 11/min. In eight patients, soda lime was used as the CO2 absorbent; in the other eight patients, Baralyme was used. During anesthesia, the concentrations of degradation products in the circuit, the temperature of the CO2 absorbent, inspired and end-tidal sevoflurane concentrations, and the volume of CO2 eliminated by the patient were measured. Gas was sampled from the inspiratory limb of the circuit and analyzed by gas chromatography. ResultsTwo degradation products, CF2=C(CF3)—O—CH2F (compound A) and CH3OCF2CH(CF3)OCH2F (compound B), were detected. In the soda lime group, the individual maximum concentration of compound A was 23.6 ± 2.9 (12.0–37.4) ppm. In the Baralyme group, the concentration was 32.0 ± 2.3 (23.5–41.3) ppm. The individual maximum concentration of compound A in the Baralyme group was significant higher than that in the soda lime group. Compound B was detected in two patients, reaching a maximum concentration of 0.2 ppm. The end-tidal sevoflurane concentration, temperature of the CO2 absorbent, and volume of CO2 eliminated by the patient were the same in both groups. ConclusionsThe degradation products detected were at low concentrations in long-duration, low-flow anesthesia with sevoflurane. Baralyme produced higher concentrations of degradation products than soda lime.