Residual volatile anesthetics after workstation preparation and activated charcoal filtration.

Acta Anaesthesiologica Scandinavica
Lukas M Müller-WirtzTobias Hüppe

Abstract

Volatile anesthetics potentially trigger malignant hyperthermia crises in susceptible patients. We therefore aimed to identify preparation procedures for the Draeger Primus that minimize residual concentrations of desflurane and sevoflurane with and without activated charcoal filtration. A Draeger Primus test workstation was primed with 7% desflurane or 2.5% sevoflurane for 2 hours. Residual anesthetic concentrations were evaluated with five preparation procedures, three fresh gas flow rates, and three distinct applications of activated charcoal filters. Finally, non-exchangeable and autoclaved parts of the workstation were tested for residual emission of volatile anesthetics. Concentrations were measured by multicapillary column-ion mobility spectrometry with limits of detection/quantification being <1 part per billion (ppb) for desflurane and <2.5 ppb for sevoflurane. The best preparation procedure included a flushing period of 10 minutes between removal and replacement of all parts of the ventilator circuit which immediately produced residual concentrations <5 ppm. A fresh gas flow of 10 L/minute reduced residual concentration as effectively as 18 L/minute, whereas flows of 1 or 5 L/minute slowed washout. Use of activated ch...Continue Reading

References

Mar 1, 1991·Anesthesiology·D J WedelJ H Milde
Sep 9, 2006·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Heike PrinzhausenGuy C Petroz
May 6, 2011·Anesthesia and Analgesia·Nathaniel BirgenheierJoseph Orr
Nov 12, 2014·Der Anaesthesist·T MetterleinM Anetseder
Jul 14, 2017·Journal of Pharmaceutical and Biomedical Analysis·Felix MaurerSascha Kreuer
Oct 4, 2019·European Journal of Anaesthesiology·Christian ThobenSebastian Heiderich

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Citations

Jul 21, 2020·Acta Anaesthesiologica Scandinavica·Lukas M Müller-WirtzTobias Hüppe
Nov 3, 2020·British Journal of Anaesthesia·Henrik RüffertUNKNOWN European Malignant Hyperthermia Group
Jun 3, 2021·Molecules : a Journal of Synthetic Chemistry and Natural Product Chemistry·Lukas Martin Müller-WirtzFelix Maurer

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