The dehydrofluorinated product of sevoflurane by soda lime reacts with ethanol to produce two products.
Dehydrofluorinated sevoflurane produced by soda lime reacted with methanol to produce methoxylated compounds. It is expected that dehydrofluorinated sevoflurane may react with ethyl alcohol in a patient who has recently ingested alcohol. In a closed vessel system and a model lung with circle absorber, sevoflurane, soda lime and ethanol were reacted at 25 degrees C. The breakdown products of sevoflurane in the gas phase were analyzed by gas chromatography and mass spectrometry. The ethoxylated compounds of dehydrofluorinated sevoflurane [fluoromethyl 2-ethoxy-2,2-difluoro-1-(trifluoromethyl)ethyl ether] and its dehydrofluorinated compound [fluoromethyl 2-ethoxy-2,2-fluoro-1-(trifluoromethyl)vinyl ether] were detected in the mixture of sevoflurane and soda lime in the presence of ethanol. In the closed vessel, the concentrations of these compounds were 69.4 +/- 6.6 ppm and 79.3 +/- 8.8 ppm, respectively, at 120 min in the presence of 11.2 mg/l of ethanol. These concentrations were dependent on the ethanol concentration. These compounds were also detected in the closed anesthetic circuit having a model lung by 180 minutes of circulation of 1.5% sevoflurane and 0.56 mg/l of ethanol with 200 ml/min carbon dioxide gas through soda lime: 24.2 +/- 4.0 ppm and 21.4 +/- 0.9 ppm, respectively. Dehydrofluorinated sevoflurane reacts with ethanol at concentrations that are within the range that may be encountered in a patient who has recently ingested alcohol to produce an ethoxylated compound, and this ethoxylated compound undergoes dehydrofluorination by soda lime.
Department of Anesthesiology and Critical Care Medicine, Hiroshima University School of Medicine, Japan.
K
K
Fujü
T
T
Az-ma
O
O
Yuge
D000764:Anesthesia, Closed-Circuit; D018685:Anesthetics, Inhalation / Q000737:chemistry*; D017610:Calcium Compounds / Q000737:chemistry; D000431:Ethanol / Q000737:chemistry*; D004987:Ethers / Q000737:chemistry*; D008401:Gas Chromatography-Mass Spectrometry; D007202:Indicators and Reagents; D008168:Lung / Q000378:metabolism; D008738:Methyl Ethers; D008953:Models, Anatomic; D010087:Oxides / Q000737:chemistry; D000077149:Sevoflurane; D012972:Sodium Hydroxide / Q000737:chemistry
D018685:Anesthetics, Inhalation; D017610:Calcium Compounds; D004987:Ethers; D007202:Indicators and Reagents; D008738:Methyl Ethers; D010087:Oxides; D000077149:Sevoflurane; D000431:Ethanol; C004569:soda lime; D012972:Sodium Hydroxide