Document Detail


A lower solubility recommends the use of desflurane more than isoflurane, halothane, and enflurane under low-flow conditions.
MedLine Citation:
PMID:  7772358     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY OBJECTIVE: To determine whether the lower solubility of desflurane, over that of isoflurane, enflurane, and halothane, favors its use in low-flow anesthesia. DESIGN: Prospective clinical study. SETTING: Technical University of Munich. PATIENTS: 40 elderly (> or = 65 yrs), ASA physical status II and III surgical patients. INTERVENTIONS: All patients were anesthetized and received delivered concentrations (FD) of 4% desflurane, 1.5% isoflurane, 1.8% enflurane, or 0.9% halothane (n = 10 patients for each anesthetic) in a fresh gas inflow of 3 L/min (high-flow), until end-tidal target concentrations (FA) of 2% desflurane, 0.5% isoflurane, 0.6% enflurane, and 0.3% halothane were obtained. After 30 minutes, the inflow was decreased to 1 L/min (low-flow), and the FD and the inspired concentration (FI) were adjusted to maintain the target concentration. MEASUREMENTS AND MAIN RESULTS: The concentrations of the halogenated anesthetics, as well as nitrous oxide, oxygen (O2), and carbon dioxide, were measured in delivered gas at the common gas outlet and at the endotracheal tube connector. Transcutaneous O2 saturation, noninvasive blood pressure, and heart rate were also measured. During the first 30 minutes of high-flow administration, the target concentration was attained sooner with desflurane than with isoflurane, enflurane, or halothane (median levels: 4 min vs. 6 min, 8 min, or 10 min; p < 0.01). After the reduction of inflow to 1 L/min, FD had to be materially increased to maintain F1 and FA for the more soluble anesthetics, but not for desflurane. CONCLUSIONS: At low flows, FD provides a reasonable surrogate of F1 and FA for desflurane, but not for isoflurane, enflurane, or halothane. The rapid and predictable titrability of desflurane favors its safe use in low-flow technique.
Authors:
S Hargasser; R Hipp; B Breinbauer; L Mielke; E Entholzner; M Rust
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of clinical anesthesia     Volume:  7     ISSN:  0952-8180     ISO Abbreviation:  J Clin Anesth     Publication Date:  1995 Feb 
Date Detail:
Created Date:  1995-07-13     Completed Date:  1995-07-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8812166     Medline TA:  J Clin Anesth     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  49-53     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Anesthesia, Inhalation / methods*
Anesthetics, Inhalation / administration & dosage,  analysis,  chemistry*
Carbon Dioxide / analysis
Enflurane / administration & dosage,  analysis,  chemistry*
Female
Halothane / administration & dosage,  analysis,  chemistry*
Humans
Isoflurane / administration & dosage,  analogs & derivatives*,  analysis,  chemistry*
Male
Nitrous Oxide / analysis
Oxygen / analysis
Prospective Studies
Rheology
Solubility
Tidal Volume
Time Factors
Chemical
Reg. No./Substance:
0/Anesthetics, Inhalation; 10024-97-2/Nitrous Oxide; 124-38-9/Carbon Dioxide; 13838-16-9/Enflurane; 151-67-7/Halothane; 26675-46-7/Isoflurane; 57041-67-5/desflurane; 7782-44-7/Oxygen
Comments/Corrections
Comment In:
J Clin Anesth. 1996 Mar;8(2):169-71   [PMID:  8695103 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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