An unrecognized power failure in a desflurane vaporizer is possible with a concomitant alarm battery failure. Premedication should be selected according to the needs of the individual patient taking into account that salivary secretions are stimulated. Full text get a printable copy pdf file of the complete article 997k, or click on a page image below to browse page by page. Available for both isoflurane and sevoflurane vaporizers, they are color coded for the specific gas anesthetics.
Desflurane vaporizer is agent specific and only desflurane has to be poured into it by special adapters. Electronic control allows for automatic record keeping, gas usage calculation, fresh gas flow compensation. Though desflurane, the volatile anesthetic agent has boiling point close to room temperature, it requires an electrically powered supplied heat vaporizer to. Desflurane is a fluorinated ether with general anesthetic and muscle relaxant activities. With prolonged use, the liquid agent may cool to the point where condensation and even frost may form on the outside of the reservoir.
Baxter stated that although the amount of discoloration from a single bottle of desflurane is imperceptible, after refilling the vaporizers repeatedly over time, these highboilingpoint discolored materials bht byproducts visibly accumulate in the sump of the vaporizer. This makes them particularly suitable for use in operating rooms where cooling or heating is an essential factor, such as in pediatric surgery, cardiac surgery, burn units, and orthopedics. It can even help you monitor and plan your anaesthesia for improved. How it works in the s5 adu, anesthetic agent control consists of two parts. Variablebypass vaporizers and the desflurane vaporizer. Severe carbon monoxide poisoning during desflurane. The filling procedure described in the manual was followed. Consequences of misfilling contemporary vaporizers with desflurane. Desflurane and sevoflurane use during low and minimalflow.
The safe delivery of volatile anaesthesia today is due in part to the development of increasingly. Should anything not be exactly right, please call your sales representative right away for help. Also, for small changes in temperature, the vapor pressure of desflurane changes quite dramatically. Suprane desflurane, usp page 5of 47 general suprane desflurane should be administered only by persons trained in the administration of general anesthesia, using a vaporizer specifically designed and designated for use with suprane. The drager vapor 2000 and dvapor can be safely operated at temperatures ranging from 10 40 c. Per the instructions of the veterans health administration warning system pt safety alert issued for electricord power cords, i will notify the manufacturer to have the device repaired or replaced as necessary. Drager vapor 3000 dvapor 3000 vaporisers for anaesthetic agents so much more than just a container for volatile agents, the new vapor 3000 series is now even better in combination with the perseus a500 anaesthesia workstation especially in dark environments.
Spontaneous shutoff of desflurane vaporizer springerlink. It works by controlling the vaporization of anesthetic agents from liquid, and then accurately controlling the concentration in which these are added to the fresh gas flow. High desflurane concentrations can influence the hotwire volume gauge. He had someone from baxter call us and fax a letter saying something to the extent of, this is an old issue, it has been investigated by the. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. The operation of dvapor depends on the direction of flow. How to make desflurane work for you use its low solubility james h philip, md. The tec 6 vaporizer used to deliver desflurane differs in design from the variable bypass concentrationcalibrated vaporizers such as the ohmeda tec 4 and tec 5 and the dragerwerk vapor 19. Pdf on dec 1, 2005, jeanchristophe geffroy and others published massive inhalation of desflurane due to vaporizer dysfunction find.
Like halothane, enflurane, and isoflurane, it is a racemic mixture of r and s optical isomers enantiomers. The new filling system is a significant improvement over previous tec filling. It is heated electrically and has both electronic monitors of vaporizer function and alarms. It can even help you monitor and plan your anaesthesia for improved efficiency. The vaporiser is connected between the freshgas flowcontrol unit and the freshgas outlet. Desflurane 1,2,2,2tetrafluoroethyl difluoromethyl ether is a highly fluorinated methyl ethyl ether used for maintenance of general anesthesia. This is followup info to previously entered report. Recovery and neurological examination after remifentanil. It is then mixed in a controlled fashion with the carrier gas. The expense and complexity of the desflurane vaporizer have contributed to the relative. Graham summary a late development model of the tec 6 vaporizer for the administration of desflurane vapour has been evaluated.
Material safety data sheet van wert county hospital. Desflurane is unsuitable for an inhalation induction because it is extremely irritating to the airway. Jan 15, 2020 desflurane has two physical properties, making it unsuitable for use with a conventional vaporizer. Data indicate that desflurane is stable when stored under normal room lighting conditions according to instructions. Physicochemical properties and pharmacodynamics of desflurane. Desfluranes unique characteristics high volatilitymoderate potency require the use of a special vaporizer for proper utilization of this gas. Desflurane has unique physical properties requiring the use of a specific desflurane vapouriser.
In group a, with the vaporizer dial fixed at 4 vol %, after an initial fresh gas flow of 4 lmin was administered to washin of desflurane using the closedcircuit, with 50% n2o in o2, and in. Desflurane causes a decrease in tidal volume and an increase in respiratory rate with an overall reduction in minute alveolar ventilation. Vaporizer interlock block port ensure plugs removed 2. Figure 11 tec 6 plus vaporizer, datexohmeda variant left, and north american drager variant right no output arm up alarm low desflurane agent tional. The tec 6 desflurane vaporizer the major problem presented by desflurane is that it is extremely volatile. To the anaesthetist, the new vaporizer does not differ from older vaporizers. To facilitate accurate delivery of desflurane, a new vaporizer has been developed,in which the anesthetic agent is converted to a gas,by heating it to a constant temperature and maintaining it at a constant pressure about 200kpa 1500 mmhg.
Among the halogenated anesthetics, desflurane possesses the highest volatility and the lowest bloodair partition coefficient 0. The record is updated if the fda identifies a violation and classifies the action as a recall, and it is updated for a final time when the recall is terminated. High desflurane settings reduce the o2 concentration in the fresh gas. Pdf massive inhalation of desflurane due to vaporizer dysfunction. The desflurane tec 6 vaporizer british journal of anaesthesia. Quick look at the characteristics of desflurane and some practical tips for when you start using it. Dvapor is inserted in the freshgas line of an anaesthesia delivery system. Your new online msds binder is a place for you to store the material safety data sheets you need to deploy. Since the washout for desflurane is more rapid than that for other inhalation agents, patients emerge from anesthesia soon after shutoff of the vaporizer. Desflurane has two physical properties, making it unsuitable for use with a conventional vaporizer.
Desflurane is a colorless, volatile liquid below 22. This material and its container must be disposed of in a safe way. The most common such vaporizer is the ohmeda tec 6, designed specifically for use with desflurane. We stopped using it completely and notified our hospital baxter representative. Modern plenum vaporizers commonly used in moredeveloped countries are. Canada dsl inventory list this product does not comply with dsl. Facilities for maintenance of a patent airway, artificial ventilation, oxygen enrichment, and circulatory resuscitation must be immediately available. Yellowing of the desflurane in vaporizer site glass. The tec 6 plus is an electronic vaporizer which heats desflurane to maintain constant temperature and vapor pressure for consistent output. Desflurane liquid fda prescribing information, side effects.
Fill devices are matched to the fill system on the vaporizer. Pdf inhalational anaesthetic agents are usually liquids at room temperature and barometric. The twentyyear globalwarming potential, gwp20, for desflurane is 3714, meaning that one tonne of desflurane emitted is equivalent to 3714 tonnes of carbon dioxide in the atmosphere, much higher than sevoflurane or isoflurane. Desflurane, usp, liquid for inhalation is administered by inhalation. Safety features include an antispill and a selectatec mechanism, and a speci. Baxter healthcare corporation suprane desflurane liquid. Vaporisers for anaesthetic agents drager vapor 3000 d.
The qualitative exceptions to this resemblence are that desflurane is more pungent and produces a greater increase in heart rate, particularly at deeper levels of anesthesia. Jan 14, 2019 desflurane should only be administered by persons trained in the administration of general anaesthesia using a vaporizer specifically designed and designated for use with desflurane. Understanding vaporizers bja education oxford academic. The tec 6 plus vaporizer adds suprane desflurane inhalant anesthetic vapor to the medical gasses supplied to a patient. From the back of the vaporizer, align the spacer block holes with the holes on the back of the vaporizer. When handling waste, the safety precautions applying to handling of the product should. Desflurane is nonflammable as defined by the requirements of international electrotechnical commission 6012.
Unlike conventional mechanical vaporizers, the desflurane vaporizer has sophisticated electronic components. The ohmeda tec 6 desflurane vaporizer datexohmeda was set between 6 and 10% to rapidly achieve a target endtidal desflurane concentration of 5%. The lungs were mechanically ventilated with a minute volume of 7 1min, a fresh gas flow of 2 1min with 100% oxygen, and a desflurane vaporizer. Vapor pressure also called saturation vapor pressure the process of evaporation in a closed container will proceed until there are as many molecules returning to the liquid as there are escaping equilibrium. How to make desflurane work for you use its low solubility james h philip, md desflurane is the anesthetic with lowest bloodgas solubility low solubility causes expired concentration to follow inspired concentration closely the inhalation route causes expired concentration to change quickly with all inhalants. The anesthesia vaporizer is a critical component of anesthetic machine. The cap from the desflurane bottle was removed, and the bottle probe was inserted into the filler port of the vaporizer. The tec 6 plus vaporizer is designed to meet ul 26011, en 606011 and iec 6012. Note that not all desflurane vaporizers are tec 6 type. Desflurane s unique characteristics high volatilitymoderate potency require the use of a special vaporizer for proper utilization of this gas. Does the vapor pressure increase when heated to 39. Highfrequency ventilation, the use of anaesthesia delivery systems with noncontinuous fresh gas flow, or the repeated activation of the o2 flush can switch off dvapor. Remove the bottle cap from the desflurane bottle and ensure that the oring is correctly fitted to the bottle probe.
It is the fastest acting induction agent big coefficient 042, potency is medium mac is 6%. Vaporisers for anaesthetic agents so much more than just a container for volatile agents, the new vapor 3000 series is now even better in combination with the perseus a500 anaesthesia workstation especially in dark environments. Inspired desflurane rises slowly because expired gas dominates over fresh gas and expired gas desflurane concentration is zero at the beginning. Desflurane and sevoflurane use during low and minimalflow anesthesia at fixed vaporizer settings. For use with any of the mindray a series anesthesia machines. We used the bottle with the missing oring successfully by merely replacing the oring. The desflurane vaporizer actively heats the liquid agent to 39 c. The number on the dial reflects the percentage that will be delivered. So at any altitude, when you dial 5%, it will give you 5%. Other companies are charging thousands of dollars to set up accounts and give you access to their msds online database. Desflurane has a very low boiling point about 23 degrees centigrade and even at room temperature, has an high vapor pressure. This means that desflurane is nearly boiling at room temperature. Introduction a vaporizer anesthetic agent or vapor delivery device changes a liquid anesthetic agent into its vapor and adds a controlled amount of that vapor to the fresh gas flow to the breathing system.
Desflurane liquid fda prescribing information, side. The vaporizer is a gasvapor blender, not a variable bypass type. Mindray drager vapor 2000 style desflurane vaporizer new. When the inspired and expired desflurane concentrations reach approximately 8% and 6% respectively, the vaporizer is adjusted to. Inhalation anesthesia is widely used in veterinary medicine. Desflurane not listed not listed not listed not listed not listed not listed not listed canadian regulations. If the desflurane temperature were to decrease, the vaporizer would fail to deliver accurate concentrations. Oct 01, 2019 only a vaporizer specifically designed and designated for use with desflurane should be utilized for its administration. Sep 16, 2015 respiratory effects desflurane is a potent respiratory depressant. All three have applications in animal research due to their rapid onset and offset with minimal side effects. Sep 15, 2010 dexter et al1 concluded in a metaanalysis that desflurane can reduce the extubation time when compared to sevoflurane. It has an led display which indicates vaporizer status no output, low agent, warmup, operational and alarm battery low.
Desflurane vaporizers are heated to 39 degrees c, which increases the vapor pressure in the sump to 0mmhg, preventing the possibility of boiling in warm or rooms. Passively vaporizing this volume of agent will result in large temperature variations that require compensation. As a failsafe, it completely halts agent output if an electronic failure occurs. Pdf total power failure in a desflurane vaporizer resulting in. An anesthetic vaporizer is a device generally attached to an anesthetic machine which delivers. Desflurane has unique physical properties requiring the use of a specific. After connecting the vaporizer and releasing the transport position, they are immediately ready for operation according to specification. Desflurane is indicated as an inhalation agent for maintenance of anesthesia for inpatient and outpatient surgery in adults. Providing an external heat source compensates for the significant heat loss associated with desflurane vaporization. Desflurane vaporisers also have a separate colour coding to identify them. Before we proceed to talk about the desflurane vaporizer, we need to understand what vapor pressure is. Together with sevoflurane, it is gradually replacing isoflurane for human use, except in economically undeveloped areas, where its high. Anaesthesia vaporizers for inhalational anaesthetic agents. Later, upon careful reexamination of the manual for the desflurane tec 6 vaporizer, we read.
Commercial desflurane vapourisers are heated above boiling point and release 100% vapour in a controlled manner. The saturated vapor pressure at room temperature 20 degrees c is 664 torr 87% of one atmosphere. How to make desflurane work for you use its low solubility. Desflurane is also less potent than other common agents minimum alveolar concentration mac 6%, and up to 18% volume percent may be delivered. Anesthetics with a high svp will require a smaller proportion of total gas flowing through the vaporizer to pass through the vaporizing chamber to produce a given concentration, than will anesthetics with a low svp thus its dangerous to administer anesthetics from vaporizers for which they were not designed. Desflurane vaporizer basic question student doctor network. Suprane desflurane, usp is nonflammable as defined by the requirements of international electrotechnical commission 6012. Aladincassette anesthetic agent vaporizer with electronic control. Only a vaporizer specifically designed and designated for use with desflurane should be utilized for its administration. I would like to bring to our readers attention an interesting finding noted recently in the operating room during refilling of a desflurane vaporizer. Mindray drager dvapor style desflurane vaporizer new does not come with quick fill adapter part number. Consequent discontinuation of desflurane delivery may go unrecognized and create the potential for intraoperative awareness and inadequate. Massive inhalation of desflurane due to vaporizer dysfunction.
This is a drager dvapor desflurane vaporizer manufactured by mindray and designed to work with any mindray a series anesthesia machine. Thus, the vaporizer slightly overcompensates for the reduced atmospheric pressure note that this does not apply to the desflurane vaporizer source 1. Desflurane 100% vv inhalation vapour, liquid summary of. Desflurane could be used in a normal vapouriser fraction diverted at 1mac 0. This potential benefit of desflurane can be especially attractive in short ambulatory cases performed with general anesthesia with a laryngeal mask airway. Its pressurized to 2atm to increase the boiling point so that it doesnt all vaporize too quickly. Vaporisers for anaesthetic agents drager vapor 3000 dvapor. In other words the boiling point of this agent is approximately at room temperature. Alternatively, the desflurane vaporizer is electrically heated to 39 degrees centigrade, which creates a vapor pressure of 2 atmospheres inside the vaporizer, regardless of ambient pressure. Jan 01, 2001 the desflurane vaporizer was then set to 3 vol% and ventilation with desflurane in oxygen was given as required.
Replacement orings are supplied with each vaporizer. Desflurane requires the use of a temperature controlled, pressure regulated vaporizer, as opposed to variable bypass. Desflurane general information dispose of waste to licensed waste disposal site in accordance with the requirements of the local waste disposal authority. To deliver an agent as sophisticated and controllable as desflurane, you need a vaporizer to match the tec tm 6 plus vaporizer from ge healthcare the tec 6 plus is an electronic vaporizer that heats desflurane to maintain constant temperature and. Desflurane is much more volatile than all the other inhalationals. Although the exact mechanism of action has not been established, desflurane, administered by inhalation, appears to act on the lipid matrix of the neuronal membrane, resulting in. I submitted a report on b6 2010 for a draeger m35500 desflurane vaporizer b4. The tec 6 vaporizer avoids this problem by heating the desflurane liquid to above its. Suprane desflurane, usp, a nonflammable liquid administered via vaporizer, is a general inhalation anesthetic. An anesthetic vaporizer is a device generally attached to an anesthetic machine which delivers a given concentration of a volatile anesthetic agent.
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