Skip to main content
Erschienen in: Journal of Clinical Monitoring and Computing 4/2018

04.01.2018 | Review Paper

Efficient application of volatile anaesthetics: total rebreathing or specific reflection?

verfasst von: Hagen Bomberg, Thomas Volk, Heinrich V. Groesdonk, Andreas Meiser

Erschienen in: Journal of Clinical Monitoring and Computing | Ausgabe 4/2018

Einloggen, um Zugang zu erhalten

Abstract

The circle system has been in use for more than a 100 years, whereas the first clinical application of an anaesthetic reflector was reported just 15 years ago. Its functional basis relies on molecular sieves such as zeolite crystals or activated carbon. In a circle system, the breathing gas is rebreathed after carbon dioxide absorption; a reflector on the other hand specifically retains the anaesthetic during expiration and resupplies it during the next inspiration. Reflection systems can be used in conjunction with intensive care ventilators and do not need the permanent presence of trained qualified staff. Because of easy handling and better ventilatory capabilities of intensive care ventilators, reflection systems facilitate the routine use of volatile anaesthetics in intensive care units. Until now, there are three reflection systems commercially available: the established AnaConDa™ (Sedana Medical, Uppsala, Sweden), the new smaller AnaConDa-S™, and the Mirus™ (Pall Medical, Dreieich, Germany). The AnaConDa consists only of a reflector which is connected to a syringe pump for infusion of liquid sevoflurane or isoflurane. The Mirus represents a technical advancement; its control unit includes a gas and ventilation monitor as well as a gas dispensing unit. The functionality, specific features, advantages and disadvantages of both systems are discussed in the text.
Literatur
1.
Zurück zum Zitat Bigelow HJ. Boston Med Surg J 1846;25: 312. Bigelow HJ. Boston Med Surg J 1846;25: 312.
2.
Zurück zum Zitat Wawersik J. [The history of anesthesia apparatus: basic principles]. Der Anaesthesist. 1982;31(10):541–8.PubMed Wawersik J. [The history of anesthesia apparatus: basic principles]. Der Anaesthesist. 1982;31(10):541–8.PubMed
3.
4.
Zurück zum Zitat Smith WD. A history of nitrous oxide and oxygen anaesthesia IVD: Henry Hill Hickman in his time. Br J Anaesth. 1978;50(6):623–7.CrossRefPubMed Smith WD. A history of nitrous oxide and oxygen anaesthesia IVD: Henry Hill Hickman in his time. Br J Anaesth. 1978;50(6):623–7.CrossRefPubMed
5.
Zurück zum Zitat Knight PR 3rd, Bacon DR. An unexplained death: Hannah Greener and chloroform. Anesthesiology. 2002;96(5):1250–3.CrossRefPubMed Knight PR 3rd, Bacon DR. An unexplained death: Hannah Greener and chloroform. Anesthesiology. 2002;96(5):1250–3.CrossRefPubMed
6.
Zurück zum Zitat Anonymous. The Roth-Drager Oxygen and Chloroform Apparatus. Br Med J. 1907;1(2418):1067–8.CrossRef Anonymous. The Roth-Drager Oxygen and Chloroform Apparatus. Br Med J. 1907;1(2418):1067–8.CrossRef
7.
Zurück zum Zitat Thomasson R, Luttropp HH, Werner O. A reflection filter for isoflurane and other anaesthetic vapours. Eur J Anaesthesiol. 1989;6(2):89–94.PubMed Thomasson R, Luttropp HH, Werner O. A reflection filter for isoflurane and other anaesthetic vapours. Eur J Anaesthesiol. 1989;6(2):89–94.PubMed
8.
Zurück zum Zitat Enlund M, Wiklund L, Lambert H. A new device to reduce the consumption of a halogenated anaesthetic agent. Anaesthesia. 2001;56(5):429–32.CrossRefPubMed Enlund M, Wiklund L, Lambert H. A new device to reduce the consumption of a halogenated anaesthetic agent. Anaesthesia. 2001;56(5):429–32.CrossRefPubMed
9.
Zurück zum Zitat Enlund M, Lambert H, Wiklund L. The sevoflurane saving capacity of a new anaesthetic agent conserving device compared with a low flow circle system. Acta Anaesthesiol Scand. 2002;46(5):506–11.CrossRefPubMed Enlund M, Lambert H, Wiklund L. The sevoflurane saving capacity of a new anaesthetic agent conserving device compared with a low flow circle system. Acta Anaesthesiol Scand. 2002;46(5):506–11.CrossRefPubMed
12.
Zurück zum Zitat Sackey PV, Martling CR, Granath F, Radell PJ. Prolonged isoflurane sedation of intensive care unit patients with the Anesthetic Conserving Device. Crit Care Med. 2004;32(11):2241–6.CrossRefPubMed Sackey PV, Martling CR, Granath F, Radell PJ. Prolonged isoflurane sedation of intensive care unit patients with the Anesthetic Conserving Device. Crit Care Med. 2004;32(11):2241–6.CrossRefPubMed
15.
Zurück zum Zitat Bomberg H, Meiser F, Daume P, Volk T, Sessler DI, Groesdonk HV, Meiser A. Halving the volume of AnaConDa: evaluation of a new small-volume anesthetic reflector in a test lung model. Anesth Analg (accept for publication with revision). 2017. Bomberg H, Meiser F, Daume P, Volk T, Sessler DI, Groesdonk HV, Meiser A. Halving the volume of AnaConDa: evaluation of a new small-volume anesthetic reflector in a test lung model. Anesth Analg (accept for publication with revision). 2017.
18.
Zurück zum Zitat Meiser A, Laubenthal H. Inhalational anaesthetics in the ICU: theory and practice of inhalational sedation in the ICU, economics, risk-benefit. Best Pract Res Clin Anaesthesiol. 2005;19(3):523–38.CrossRefPubMed Meiser A, Laubenthal H. Inhalational anaesthetics in the ICU: theory and practice of inhalational sedation in the ICU, economics, risk-benefit. Best Pract Res Clin Anaesthesiol. 2005;19(3):523–38.CrossRefPubMed
19.
Zurück zum Zitat Bomberg H, Veddeler M, Volk T, Groesdonk HV, Meiser A. Volumetric and reflective device dead space of anaesthetic reflectors under different conditions. J Clin Monit Comput (accept for publication). 2017. Bomberg H, Veddeler M, Volk T, Groesdonk HV, Meiser A. Volumetric and reflective device dead space of anaesthetic reflectors under different conditions. J Clin Monit Comput (accept for publication). 2017.
Metadaten
Titel
Efficient application of volatile anaesthetics: total rebreathing or specific reflection?
verfasst von
Hagen Bomberg
Thomas Volk
Heinrich V. Groesdonk
Andreas Meiser
Publikationsdatum
04.01.2018
Verlag
Springer Netherlands
Erschienen in
Journal of Clinical Monitoring and Computing / Ausgabe 4/2018
Print ISSN: 1387-1307
Elektronische ISSN: 1573-2614
DOI
https://doi.org/10.1007/s10877-017-0096-x

Weitere Artikel der Ausgabe 4/2018

Journal of Clinical Monitoring and Computing 4/2018 Zur Ausgabe

Update AINS

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.