低流量七氟烷吸入麻醉时不同二氧化碳吸收剂环路中化合物A浓度的比较及其对患者肝肾功能的影响

Compound A concentrations in breathing circuit with different carbon dioxide absorbents during low-flow sevoflurane anesthesia

Objective To investigate the influence of different carbon dioxide (CO2) absorbents (Dr(a)gersorb 800 plus , Sodasorb,Sodasorb LF) on the production of compound A during low-flow sevoflurane anesthesia.Methods Twenty-seven ASA Ⅰ or Ⅱ patients aged 20-64 years were randomly assigned to three groups according to different CO2 absorbents: Dr(a)gersorb 800 plus' group (group D, n = 10), Sodasorb group (group S, n = 10) and Sodasorb LF group (group LF, n = 7). Anesthesia was maintained with low-flow (500 ml/min) sevoflurane inhalation (with the end-tidal sevoflurane concentration of approximately 2% ). At 2 h after low-flow sevoflurane anesthesia, gas samples were taken from the expiratory limb of the circuit. Compound A was detected by gas chromatography. Serum alanine transaminase (ALT), aspartate aminotransferase (AST), bilirubin (BR), urea nitrogen (BUN) and creatinine (Cr) levels were measured before (T0 ) and 24 h after operation (T1).Results The three groups were comparable with respect to age, body weight and height. After 2 h of low-flow sevoflurane anesthesia, compound A concentrations in the expiratory limb of the circuit were 11.6 ± 5.8 (group D), 2.1 ± 1.9 (group S)and ＜ 0.1 ppm (group LF), respectively. There were no significant changes in the serum ALT, AST, BR, BUN and Cr levels at 24 h after operation as compared with the preoperative baseline values in the three groups.Conclusion After 2 h of low-flow (500 ml/min) sevoflurane anesthesia, compound A concentrations within the circuit with different CO2 absorbents ( Dr(a)gersorb 800 plus' , Sodasorb, Sodasorb LF) are less than 50 ppm, with the lowest in Sodasorb LF.However, they have no significant effects on hepatic or renal function.