Sevoflurane degradation to compound A in anaesthesia breathing systems

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Abstract

Determination of an effective rate constant and activation energy allowed the application of steady-state theory to predict concentrations of compound A from sevoflurane concentrations, fresh gas flow rate, absorbent temperature and amount of absorbent. Studies by eight research groups were compared. Lower concentrations of compound A than predicted were observed at low flow rates, suggesting that its degradation by the absorbent is important in limiting the maximum observed concentrations in closed and low-flow breathing systems. Trial-to-trial and batch-to-batch variations in compound A concentrations were observed in model system tests of commercial and pilot-plant absorbents. Chemical modification of the absorbent with glycerol lowered concentrations of compound A, possibly by formation of a nucleophilic addition product. An ideal chemical scavenger would remain stable and non-volatile in the absorbent before irreversibly reacting with compound A to form a stable non-volatile product.

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Cunningham, D. D., Huang, S., Webster, J., Mayoral, J., & Grabenkort, R. W. (1996). Sevoflurane degradation to compound A in anaesthesia breathing systems. British Journal of Anaesthesia, 77(4), 537–543. https://doi.org/10.1093/bja/77.4.537

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