Absorption and Degradation of Sevoflurane and Isoflurane in a Conventional Anesthetic Circuit

Abstract

Soda lime and Baralyme degrade sevoflurane, the rate of degradation being a direct function of temperature. We tested whether this degradation would impede the development of an anesthetizing concentration of sevoflurane (compared with isoflurane, a compound that is not degraded) in a circle-absorption system having an increased temperature consequent to (a) carbon dioxide production (200 mL/min) and absorption; and (b) a low inflow rate (70 mL/min). We also measured the temperatures reached in various parts of the absorption system when used in clinical practice, finding that peak temperatures usually reached 37 degrees - 46 degrees C when low inflow rates (500 mL/min) were applied. The tests in the model system demonstrated that soda lime and Baralyme absorbed both sevoflurane and isoflurane, and that both absorbants degraded sevoflurane but not isoflurane. Baralyme produced a fourfold greater degradation of sevoflurane vapor than did soda lime (0.66 mL/min compared with 0.17 mL/min). However, except for a slight delay at the start of anesthesia, neither absorption nor degradation should noticeably affect the requirement for anesthetic delivery in clinical practice, even in low-flow systems.