Baralyme[registered sign] Dehydration Increases and Soda Lime Dehydration Decreases the Concentration of Compound A Resulting from Sevoflurane Degradation in a Standard Anesthetic Circuit

1997 ◽  
Vol 85 (4) ◽  
pp. 892-898 ◽  
Author(s):  
Edmond I Eger ◽  
Pompiliu Ionescu ◽  
Michael J. Laster ◽  
Richard B. Weiskopf
Keyword(s):  
Soda Lime ◽  
Compound A ◽  
Anesthetic Circuit

Effects of the Water Content of Soda Lime on Compound A Concentration in the Anesthesia Circuit in Sevoflurane Anesthesia 

1998 ◽  
Vol 88 (1) ◽  
pp. 66-71 ◽  
Author(s):  
Hiromichi Bito ◽  
Yukako Ikeuchi ◽  
Kazuyuki Ikeda
Keyword(s):  
Gas Flow ◽  
Soda Lime ◽  
Absorption Capacity ◽  
Low Flow ◽  
Co2 Absorption ◽  
Sevoflurane Anesthesia ◽  
Compound A ◽  
Carbon Dioxide Co2 ◽  
End Tidal ◽  
Co2 Elimination

Background Sevoflurane anesthesia is usually performed with fresh gas flow 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 flow of 1 l/min) was performed in 37 patients using soda lime with water added (perhydrated soda lime) or standard soda lime as the carbon dioxide (CO2) absorbent. The soda lime was not changed between patients, but rather was used until CO2 rebreathing occurred. The perhydrated soda lime was prepared by spraying 100 ml distilled water 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 CO2 and end-tidal sevoflurane concentrations, and CO2 elimination by the patient were 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 CO2 elimination. Compound A concentration decreased with the total time of soda lime use for both types of soda lime. The CO2 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 CO2 absorption capacity of the soda lime is reduced by adding water to it, but this should not be clinically significant.

The Anesthesia Machine: Managing Exhaled and Waste Gases

2019 ◽  
Author(s):  
Christine Jette
Keyword(s):  
Carbon Monoxide ◽  
Malignant Hyperthermia ◽  
Operating Room ◽  
Improve Patient Safety ◽  
Soda Lime ◽  
Anesthesia Machine ◽  
Co2 Absorption ◽  
Carbon Dioxide Absorption ◽  
Compound A ◽  
Anesthetic Gases

Effective and safe CO2 absorption is critical to the anesthesia circle system to prevent rebreathing and hypercapnia. Advances in the original soda lime–based absorbents and their container systems continue to improve patient safety, reducing the risk of compound A and carbon monoxide production, with seemingly little compromise to the efficiency of CO2 absorption capabilities. Scavenging systems and the removal of waste anesthesia gases remain a critical component to anesthesia care, and vigilance to maintain approved systems is a key to operating room staff safety. Advances in anesthesia machine design have resulted in more complicated internal breathing circuits that are increasingly difficult to rid of trace anesthetic gases. This inadvertently led to a necessary change in guidelines on anesthesia machine preparation for patients susceptible to malignant hyperthermia (MH).   This review contains 5 figures, 6 tables, and 59 references. Keywords: carbon dioxide absorption, carbon monoxide, CO2 absorption, compound A, malignant hyperthermia machine preparation, operating room safety, scavenging systems, waste anesthesia gases

Factors Affecting Production of Compound A from the Interaction of Sevoflurane with Baralyme Registered Trademark and Soda Lime

1996 ◽  
Vol 82 (4) ◽  
pp. 775-781
Author(s):  
Z. X. Fang ◽  
L. Kandel ◽  
M. J. Laster ◽  
P. Ionescu ◽  
E. I Eger
Keyword(s):  
Soda Lime ◽  
Compound A ◽  
Factors Affecting ◽  
Registered Trademark

Lack of Degradation of Sevoflurane by a New Carbon Dioxide Absorbent in Humans

2001 ◽  
Vol 94 (6) ◽  
pp. 1007-1009 ◽  
Author(s):  
Ali Mchaourab ◽  
Shahbaz R. Arain ◽  
Thomas J. Ebert
Keyword(s):  
Carbon Dioxide ◽  
Gas Flow ◽  
Blood Gases ◽  
Soda Lime ◽  
Barium Hydroxide ◽  
Arterial Blood Gases ◽  
Compound A ◽  
Arterial Blood ◽  
Co2 Absorbent ◽  
End Tidal

Background Potent inhaled anesthetics degrade in the presence of the strong bases (sodium hydroxide or potassium hydroxide) in carbon dioxide (CO2) absorbents. A new absorbent, Amsorb (Armstrong Medical Ltd., Coleraine, Northern Ireland), does not employ these strong bases. This study compared the scavenging efficacy and compound A production of two commercially available absorbents (soda lime and barium hydroxide lime) with Amsorb in humans undergoing general anesthesia. Methods Four healthy volunteers were anesthetized on different days with desflurane, sevoflurane, enflurane, and isoflurane. End-tidal carbon dioxide (ETCO2) and anesthetic concentrations were measured with infrared spectroscopy; blood pressure and arterial blood gases were obtained from a radial artery catheter. Each anesthetic exposure lasted 3 h, during which the three fresh (normally hydrated) CO2 absorbents were used for a period of 1 h each. Anesthesia was administered with a fresh gas flow rate of 2 l/min of air:oxygen (50:50). Tidal volume was 10 ml/kg; respiratory rate was 8 breaths/min. Arterial blood gases were obtained at baseline and after each hour. Inspired concentrations of compound A were measured after 15, 30, and 60 min of anesthetic administration for each CO2 absorbent. Results Arterial blood gases and ETCO2 were not different among three CO2 absorbents. During sevoflurane, compound A formed with barium hydroxide lime and soda lime, but not with Amsorb. Conclusions This new CO2 absorbent effectively scavenged CO2 and was not associated with compound A production.

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