Effects of the water content of soda lime on compound A concentration in the anesthesia circuit in sevoflurane anesthesia
Effects of the water content of soda lime on compound A concentration in the anesthesia circuit in sevoflurane anesthesia
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DOI：
10.1097/00000542-199801000-00012
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发表时间：
1998-01-01
期刊：
影响因子：
8.8
通讯作者：
Ikeda, K
中科院分区：
文献类型：
--
作者：
Bito, H;Ikeuchi, Y;Ikeda, K
背景：由于化合物 A 对大鼠的毒性以及低流量系统中七氟醚的临床经验有限，七氟醚麻醉通常采用大于 2 l/min 的新鲜气体进行，然而，为了降低成本，确定降低低流量七氟醚麻醉中化合物 A 浓度的方法将是有用的。本研究的目的是确定使用加水的钠石灰是否可以降低化合物 A 的浓度。方法：使用加水的钠石灰（过水合钠石灰）或标准钠石灰作为二氧化碳 (CO(2)) 吸收剂，对 37 名患者进行低流量七氟醚麻醉（新鲜气体为 1 U/min）。不同患者之间不更换钠石灰，而是一直使用直至发生 CO(2) 再呼吸。通过将 100 ml 蒸馏物喷洒到 1 kg 新鲜钠石灰上制备过水钠石灰，并且仅在将一袋新钠石灰放入罐中时才添加水。循环系统中的化合物 A 浓度、钠石灰温度、吸入和呼气末 CO(2) 和呼气末七氟醚浓度以及患者在麻醉过程中排出的 CO(2) 浓度仅进行测量。结果：化合物 A 浓度显着低于麻醉期间的患者。全水合钠石灰（1.9 +/- 1.8 ppm；意味着+/- SD）比标准钠石灰（13.9 +/- 8.2 ppm）高。两种类型的钠石灰在钠石灰温度、潮气末七氟烷浓度或 CO(2) 消除方面没有差异。对于两种类型的碱石灰，化合物 A 的浓度随着碱石灰酶的总时间而降低。过水合钠石灰的 CO(2) 吸收能力明显低于标准钠石灰。结论：使用加水的钠石灰可以降低回路中化合物 a 的浓度。碱石灰的 CO(2) 吸收能力因添加物质而降低，但这不应具有临床意义。
Background: Sevoflurane anesthesia is usually performed with fresh gas Bow rates greater than 2 l/min due to the toxicity of compound A in rats and limited clinical experience with sevoflurane in low-flow systems, However, to reduce costs, it would be useful to identify ways to reduce compound A concentrations in low-flow sevoflurane anesthesia. This goal of this study was to determine if compound A concentrations can be reduced by using soda lime with water added.Methods: Low-flow sevoflurane anesthesia (fresh gas from of 1 U/min) was performed in 37 patients using soda lime with water added (perhydrated soda lime) or standard soda lime as the carbon dioxide (CO(2)) absorbent. The soda lime was not changed between patients, but rather mas used until CO(2) rebreathing occurred. The perhydrated soda lime mas prepared by spraying 100 ml distilled mater onto 1 kg fresh soda lime, and water was added only when a new bag of soda lime was placed into the canister, Compound A concentrations in the circle system, soda lime temperatures, inspired and end-tidal CO(2) and end-tidal sevoflurane concentrations, and CO(2) elimination by the patient mere measured during anesthesia.Results: Compound A concentrations were significantly lower for the perhydrated soda lime (1.9 +/- 1.8 ppm; means +/- SD) than for the standard soda lime (13.9 +/- 8.2 ppm). No differences were seen between the two types of soda lime with regard to the temperature of the soda lime, end-tidal sevoflurane concentrations, or CO(2) elimination. Compound A concentration decreased with the total time of soda lime ase for both types of soda lime. The CO(2) absorption capacity was significantly less for perhydrated soda lime than for standard soda lime.Conclusions: Compound a concentrations in the circuit can be reduced by using soda lime with water added. The CO(2) absorption capacity of the soda lime is reduced by adding mater to it, but this should not be clinically significant.