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BJA Advance Access published online on December 10, 2004
British Journal of Anaesthesia, doi:10.1093/bja/aei051
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2004
Accepted October 22, 2004

Laboratory Investigation

Time course of inhaled anaesthetic drug delivery using a new multifunctional closed-circuit anaesthesia ventilator. In vitro comparison with a classical anaesthesia machine{dagger}

M. M. R. F. Struys 1*, A. F. Kalmar 1, L. E. C. De Baerdemaeker 1, E. P. Mortier 1, G. Rolly 1, J. Manigel 2, and W. Buschke 3

1 Department of Anaesthesia, Ghent University Hospital, De Pintelaan 185, B-9000 Gent, Belgium
2 Research and Development, Business Unit Anesthesia, Dräger Medical, Lübeck, Germany
3 Product Management, Business Unit Anesthesia, Dräger Medical, Lübeck, Germany

* To whom correspondence should be addressed.
M. M. R. F. Struys, E-mail: michel.struys{at}ugent.be


  Abstract

Background. The aim of this study was to detail the time-course, defined as the changes in end-tidal drug concentration with time, and consumption of inhaled anaesthetics when using a multifunctional closed-circuit anaesthesia machine in various drug delivery modes, and to compare it with a classical anaesthesia machine using an out-of-circle vaporizer under high and low fresh gas flow conditions.

Methods. Using an artificial test lung, sevoflurane and desflurane time-course and consumption were compared when using the Zeus® apparatus (Dräger, Lübeck, Germany) with direct injection of inhaled anaesthetics or the Primus® apparatus (Dräger, Lübeck, Germany) using a classical out-of-circle vaporizer. Anaesthetics were targeted at 1 and 2 MAC end-tidal during 15 min. For both apparatus, out-of-circle high and low fresh gas control (FGC) and for Zeus®, auto-control (AC) modes (fixed fresh gas flow at 6 and 1 litre min-1 and uptake mode) were compared. Time to reach target, initial overshoot and stability at target, and wash-out times were compared.

Results. In FGC, an initial overshoot in end-tidal drug concentration is seen when using 6 litre min-1 fresh gas flow and a slower time course is observed when using only 1 litre min-1 in both apparatus. In auto-control mode, the time course of both sevoflurane and desflurane was very fast and not influenced by the changes in fresh gas flow. No overshoot at target was seen. At all settings, the wash-out times were faster when using Zeus® than Primus®. Inhaled anaesthetic consumption was lowest with the Zeus® ventilator in uptake AC mode.

Conclusion. A combination of the fastest time course and lowest consumption of sevoflurane and desflurane was found when using the Zeus® apparatus in AC uptake mode.

Keywords: anaesthetics, volatile; equipment, ventilators; ventilation, fresh gas flow.
{dagger} Declaration of interest. Dr Manigel and Mr Buschke are employees of Dräger Medical, Lübeck, Germany. The Zeus® ventilator was kindly loaned to the Department of Anaesthesia, Ghent University Hospital by Dräger Medical.
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