Sofnolime with Different Water Content Causes Different Effects in Two Sevoflurane Inhalational Induction Techniques with Respect to the Output of Compound-A

Objective: During sevoflurane anesthesia with Sofnolime for CO2 absorption, the factors affecting the production of compound A (a chemical is nepherotoxic) are still not clear. This study is designed to investigate the effects of different fresh gas flow during induction, the vital capacity induction (VCI) vs. the tidal volume breath induction (TBI) on the compound-A production with a fresh Sofnolime or a dehydrated Sofnolime using a simulated lung model. Method: The experiments were randomly divided into four groups: group one, VCIf, vital capacity fresh gas inflow with fresh Sofnolime; group two, TBIf, tidal volume breath fresh gas inflow with fresh Sofnolime; group three, VCId, vital capacity fresh gas inflow with dehydrated Sofnolime, and group four, TBId, tidal volume breath fresh gas inflow with dehydrated Sofnolime. The inspired sevoflurane was maintained at 8%, the concentrations of compound-A were assayed using Gas-spectrum technique, and Sofnolime temperatures were monitored at 1-min intervals throughout the experiment. Results: The mean and maximum concentrations of compound A were significantly higher in the vital capacity group than the tidal volume breath group (P<0.01). At the beginning of anesthesia maintenance, the compound-A concentration in group VCIf was 36.28±6.13 ppm, which was significantly higher than the 27.32±4.21 ppm observed in group TBIf (P<0.01). However, these values decreased to approximately 2 ppm in the dehydrated Sofnolime groups. Sofnolime temperatures increased rapidly in the dehydrated Sofnolime groups but slowly in the fresh Sofnolime groups. Conclusion: With fresh Sofnolime, vital capacity induction increased compound-A production in the circuit system compared with tidal volume breath induction. However, with dehydrated Sofnolime, the effects of the two inhalation induction techniques on compound-A output were not significantly different.

[1]  Bo Sun,et al.  A comparison between vital capacity induction and tidal breathing induction techniques for the induction of anesthesia and compound A production. , 2010, Chinese medical journal.

[2]  Chun-xia Shi,et al.  Sevoflurane postconditioning protects isolated rat hearts against ischemia-reperfusion injury. , 2010, Chinese medical journal.

[3]  Yun-tai Yao,et al.  Sevoflurane postconditioning protects isolated rat hearts against ischemia-reperfusion injury: the role of radical oxygen species, extracellular signal-related kinases 1/2 and mitochondrial permeability transition pore , 2010, Molecular Biology Reports.

[4]  F. Donati,et al.  Low-dose fentanyl-midazolam combination improves sevoflurane induction in adults , 2009, Canadian journal of anaesthesia = Journal canadien d'anesthesie.

[5]  A. Cros,et al.  Target‐controlled inhalation induction with sevoflurane in children: a prospective pilot study , 2009, Paediatric anaesthesia.

[6]  Heng Li,et al.  SEVOFLURANE POST‐CONDITIONING PROTECTS AGAINST MYOCARDIAL REPERFUSION INJURY BY ACTIVATION OF PHOSPHATIDYLINOSITOL‐3‐KINASE SIGNAL TRANSDUCTION , 2008, Clinical and experimental pharmacology & physiology.

[7]  F. Xue,et al.  Clinical experience of airway management and tracheal intubation under general anesthesia in patients with scar contracture of the neck. , 2008, Chinese medical journal.

[8]  Jah-yao Liu,et al.  Single vital-capacity and successive tidal-volume breathing of sevoflurane in induction of anesthesia for tracheal intubation in gynecologic patients. , 2008, Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists.

[9]  E. Eger,et al.  Fires from the Interaction of Anesthetics with Desiccated Absorbent , 2004, Anesthesia and analgesia.

[10]  E. Kharasch,et al.  Dose-dependent metabolism of fluoromethyl-2,2-difluoro-1-(trifluoromethyl)vinyl ether (compound A), an anesthetic degradation product, to mercapturic acids and 3,3,3-trifluoro-2-(fluoromethoxy)propanoic acid in rats. , 1999, Toxicology and applied pharmacology.

[11]  Baker,et al.  Sevoflurane: a comparison between vital capacity and tidal breathing techniques for the induction of anaesthesia and laryngeal mask airway placement , 1999, Anaesthesia.

[12]  M. Gruber,et al.  Dry soda lime markedly degrades sevoflurane during simulated inhalation induction. , 1999, British journal of anaesthesia.

[13]  H. Wilke,et al.  Clinical Pharmacokinetics of Sevoflurane , 1999, Clinical pharmacokinetics.

[14]  K. Ikeda,et al.  Effects of the Water Content of Soda Lime on Compound A Concentration in the Anesthesia Circuit in Sevoflurane Anesthesia , 1998, Anesthesiology.

[15]  K. Ikeda,et al.  Partly exhausted soda lime or soda lime with water added, inhibits the increase in compound A concentration in the circle system during low-flow sevoflurane anaesthesia. , 1997, British journal of anaesthesia.

[16]  M. Harmer,et al.  Single‐breath inhalation induction of sevoflurane anaesthesia with and without nitrous oxide: a feasibility study in adults and comparison with an intravenous bolus of propofol , 1997, Anaesthesia.

[17]  O. Yuge,.  Renal toxicity of compound A with sevoflurane anesthesia: The benefits of sevoflurane appear to outweigh the risks , 1997, Journal of anesthesia.

[18]  R. Weiskopf,et al.  Nephrotoxicity of Sevoflurane Versus Desflurane Anesthesia in Volunteers , 1997, Anesthesia and analgesia.

[19]  E. Kharasch,et al.  Role of Renal Cysteine Conjugate beta‐Lyase in the Mechanism of Compound A Nephrotoxicity in Rats , 1997, Anesthesiology.

[20]  D. Cunningham,et al.  Sevoflurane degradation to compound A in anaesthesia breathing systems. , 1996, British journal of anaesthesia.

[21]  E. Eger,et al.  Factors Affecting Production of Compound A from the Interaction of Sevoflurane with Baralyme Registered Trademark and Soda Lime , 1996, Anesthesia and analgesia.

[22]  P. Prokocimer,et al.  Inhalation Toxicity Study of a Haloalkene Degradant of Sevoflurane, Compound A (PIFE), in Sprague‐Dawley Rats , 1995, Anesthesiology.

[23]  E. Eger,et al.  Toxicity of Compound A in Rats: Effect of a 3‐Hour Administration , 1994, Anesthesiology.

[24]  E. Eger,et al.  Toxicity of Compound A in Rats: Effect of Increasing Duration of Administration , 1994, Anesthesiology.

[25]  Y. Ogasawara,et al.  Reaction of sevoflurane and its degradation products with soda lime. Toxicity of the byproducts. , 1992, Anesthesiology.

[26]  E. Eger,et al.  Absorption and Degradation of Sevoflurane and Isoflurane in a Conventional Anesthetic Circuit , 1991, Anesthesia and analgesia.

[27]  J. L. Rosenberger,et al.  Rapid induction of halothane anaesthesia in man. , 1985, British journal of anaesthesia.