Sevoflurane is unstable in contact with Soda Lime (NaOH), especially when administered with low fresh gas flows, and produces a degradation product Compound A which causes renal necrosis in rats. In humans, it is found to cause proteinuria and enymuria which are dose-related but renal toxicity itself has not been unequivocally shown. The requirement that sevoflurane be administered with a minimum fresh gas flow of 2 liters per minute makes sevoflurane a relatively expensive choice for maintaining general anesthesia.
Sevoflurane is not corrosive to stainless steel, brass, aluminum, nickel-plated brass, chrome-plated brass or copper beryllium.
Sevoflurane degradation and subsequent degradant formation are enhanced by increasing absorbent temperature increased sevoflurane concentration, decreased fresh gas flow and desiccated CO absorbents (especially with potassium hydroxide containing absorbents e.g.
In a clinical study in which sevoflurane was administered to patients under low flow conditions for ≥ 2 hours at flow rates of 1 Liter/minute, Compound A levels were measured in an effort to determine the relationship between MAC hours and Compound A levels produced.
Sevoflurane (2,2,2-trifluoro-1-[trifluoromethyl] fluoromethyl ether), also called fluoromethyl, is a sweet-smelling, non-flammable, highly fluorinated methyl isopropyl ether used for induction and maintenance of general anesthesia.
In contact with the soda lime in a rebreathing apparatus that serves as carbon dioxide absorber sevoflurane forms at least two degradation products, Compound A [fluoromethyl-2,2-difluoro-1-(trifluoromethyl)vinyl ether] and Compound B [1,1,1,3,3-pentafluoro-2-(fluoromethoxy)-3-methoxypropane], especially at higher temperatures and when the soda lime is desiccated.
As a result, sevoflurane is sometimes administered with a minimum fresh gas flow of 2 liters per minute, making it a relatively expensive choice for maintaining general anesthesia.
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