Consequences of misfilling contemporary vaporizers with desflurane

J. Jeff Andrews, Robert V. Johnston, George C. Kramer

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

Desflurane is a volatile anaesthetic that combines low blood gas solubility (blood/gas partition coefficient =0.42 at 37° C), moderate potency (MAC = 6-7%), and high volatility (vapour pressure =681 mmHg at 20° C, boiling point = 23.5° C). The volatility and potency of desflurane prevent its safe use in vaporizers of traditional design. We present a mathematical model which demonstrates the potential for desflurane overdose if contemporary vaporizers are misfilled with desflurane. The most hazardous filling error occurs if an enflurane vaporizer is misfilled with desflurane. The calculated desflurane output of a misfilled enflurane vaporizer at a dial setting of 1% and a temperature of 22° C is 57.8%, or 9.6 MAC. For misfilled enflurane, isoflurane, and halothane vaporizers at dial settings equivalent to one MAC at 22° C, the calculated desflurane output is 14.0, 10.2, and 7.8 MAC, respectively. We conclude that the safe delivery of desflurane will require engineering safeguards, additional monitoring, and education of the anesthesia community.

Original languageEnglish (US)
Pages (from-to)71-76
Number of pages6
JournalCanadian Journal of Anaesthesia
Volume40
Issue number1
DOIs
StatePublished - Jan 1993

Keywords

  • anaesthetics, gases: desflurane
  • equipment: vaporizers

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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