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Wash-in kinetics for sevoflurane using a disposable delivery system (AnaConDa (R)) in cardiac surgery patients

Walther Sturesson, Louise LU ; Johansson, Arne LU ; Bodelsson, Mikael LU and Malmkvist, Gunnar LU (2009) In British Journal of Anaesthesia 102(4). p.470-476
Abstract
The use of volatile anaesthetics has increased in situations where conventional anaesthetic machines are inadequate or unavailable, for example, cardiac surgery and intensive care. The disposable anaesthetic conserving device, AnaConDa (R), allows vaporization of liquid volatile anaesthetics from a syringe pump and rebreathing of exhaled anaesthetic. Clinical use requires understanding of device-specific anaesthetic agent kinetics, which are not fully known. We compared the wash-in kinetics for sevoflurane administered by a conventional vaporizer in a non-rebreathing system and the AnaConDa (R) and evaluated if a standard anaesthesia gas monitor gave accurate readings while using the AnaConDa (R). Cardiac surgery patients were randomized... (More)
The use of volatile anaesthetics has increased in situations where conventional anaesthetic machines are inadequate or unavailable, for example, cardiac surgery and intensive care. The disposable anaesthetic conserving device, AnaConDa (R), allows vaporization of liquid volatile anaesthetics from a syringe pump and rebreathing of exhaled anaesthetic. Clinical use requires understanding of device-specific anaesthetic agent kinetics, which are not fully known. We compared the wash-in kinetics for sevoflurane administered by a conventional vaporizer in a non-rebreathing system and the AnaConDa (R) and evaluated if a standard anaesthesia gas monitor gave accurate readings while using the AnaConDa (R). Cardiac surgery patients were randomized to maintenance of anaesthesia with sevoflurane either via a vaporizer or via the AnaConDa (R) (n=8 in each group). Sevoflurane in arterial blood and airway gas was measured with gas chromatography and standard gas monitoring. The initial increase in arterial sevoflurane tension was greater with the vaporizer than with the AnaConDa (R), but the time to reach 80% of maximum sevoflurane tension was close to 8 min in both groups. End-tidal sevoflurane tension mirrored arterial tension in both groups, whereas measured inspired tension was lower than expired and arterial tensions with the use of the AnaConDa (R). The wash-in kinetics for sevoflurane delivered by the AnaConDa (R) are similar to a vaporizer. End-tidal sevoflurane tension accurately reflects arterial tension whereas inspired tension may be underestimated using an AnaConDa (R). (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
model, anaesthetics volatile, pharmacokinetics
in
British Journal of Anaesthesia
volume
102
issue
4
pages
470 - 476
publisher
Macmillan
external identifiers
  • wos:000264189700005
  • pmid:19244261
  • scopus:62549096755
ISSN
1471-6771
DOI
10.1093/bja/aep019
language
English
LU publication?
yes
id
8b34dfc8-3596-4f8f-a59a-92b15e027c0e (old id 1404978)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19244261?dopt=Abstract
date added to LUP
2009-06-15 09:58:20
date last changed
2017-01-01 04:28:34
@article{8b34dfc8-3596-4f8f-a59a-92b15e027c0e,
  abstract     = {The use of volatile anaesthetics has increased in situations where conventional anaesthetic machines are inadequate or unavailable, for example, cardiac surgery and intensive care. The disposable anaesthetic conserving device, AnaConDa (R), allows vaporization of liquid volatile anaesthetics from a syringe pump and rebreathing of exhaled anaesthetic. Clinical use requires understanding of device-specific anaesthetic agent kinetics, which are not fully known. We compared the wash-in kinetics for sevoflurane administered by a conventional vaporizer in a non-rebreathing system and the AnaConDa (R) and evaluated if a standard anaesthesia gas monitor gave accurate readings while using the AnaConDa (R). Cardiac surgery patients were randomized to maintenance of anaesthesia with sevoflurane either via a vaporizer or via the AnaConDa (R) (n=8 in each group). Sevoflurane in arterial blood and airway gas was measured with gas chromatography and standard gas monitoring. The initial increase in arterial sevoflurane tension was greater with the vaporizer than with the AnaConDa (R), but the time to reach 80% of maximum sevoflurane tension was close to 8 min in both groups. End-tidal sevoflurane tension mirrored arterial tension in both groups, whereas measured inspired tension was lower than expired and arterial tensions with the use of the AnaConDa (R). The wash-in kinetics for sevoflurane delivered by the AnaConDa (R) are similar to a vaporizer. End-tidal sevoflurane tension accurately reflects arterial tension whereas inspired tension may be underestimated using an AnaConDa (R).},
  author       = {Walther Sturesson, Louise and Johansson, Arne and Bodelsson, Mikael and Malmkvist, Gunnar},
  issn         = {1471-6771},
  keyword      = {model,anaesthetics volatile,pharmacokinetics},
  language     = {eng},
  number       = {4},
  pages        = {470--476},
  publisher    = {Macmillan},
  series       = {British Journal of Anaesthesia},
  title        = {Wash-in kinetics for sevoflurane using a disposable delivery system (AnaConDa (R)) in cardiac surgery patients},
  url          = {http://dx.doi.org/10.1093/bja/aep019},
  volume       = {102},
  year         = {2009},
}