title: Vapor Pressures of Anesthetic Agents at Temperatures Below 0°C and a Novel Anesthetic Delivery Device.
abstract: At room temperature, the vapor pressures of desflurane, isoflurane, and sevoflurane are well above the clinically useful range. We hypothesized that therapeutic concentrations of these agents could be achieved at temperatures below 0°C, but the vapor pressure-temperature relationship is unknown below 0. Second, we hypothesized that this relationship could be exploited to deliver therapeutic-range concentrations of anesthetic vapor. We therefore set out to determine the low temperature-vapor pressure relationships of each anesthetic agent, thereby identifying the saturated vapor concentration of each agent at any temperature below 0°C. To test our hypothesis, we measured the saturated vapor concentration at 1 atm of pressure for temperatures between -60 and 0°C, thus developing an empiric relationship for each agent. There was consistency in repeated experiments for all 3 agents. To test the empiric data, we constructed a digitally controlled thermoelectric anesthetic vaporizer, characterized the device, and used it to deliver anesthetic vapor to laboratory mice. We report, for the first time, the temperature-vapor pressure relationship at temperatures below 0°C for desflurane, isoflurane, and sevoflurane as well as the TMAC of these agents: the temperature at which the vapor pressure is equal to the minimum alveolar concentration. We describe the construction and limited validation of an anesthetic vaporizer prototype on the basis of this principle. We conclude that clinically relevant concentrations of volatile anesthetics may be achieved at low temperatures.
authors.affiliation: From the Oregon Health & Science University, Portland, Oregon.
authors.forename: Katie J
authors.initials: KJ
authors.lastname: Schenning
authors.forename: Henry
authors.initials: H
authors.lastname: Casson
authors.forename: Sarah V
authors.initials: SV
authors.lastname: Click
authors.forename: Lucas
authors.initials: L
authors.lastname: Brambrink
authors.forename: Thomas T
authors.initials: TT
authors.lastname: Chatkupt
authors.forename: Nabil J
authors.initials: NJ
authors.lastname: Alkayed
authors.forename: Michael P
authors.initials: MP
authors.lastname: Hutchens
mesh_terms: D018685:Anesthetics, Inhalation / Q000008:administration & dosage / Q000737:chemistry* / Q000378:metabolism; D000818:Animals; D003080:Cold Temperature; D000077335:Desflurane; D016503:Drug Delivery Systems; D005260:Female; D007530:Isoflurane / Q000031:analogs & derivatives / Q000737:chemistry; D008738:Methyl Ethers / Q000737:chemistry; D051379:Mice; D008810:Mice, Inbred C57BL; D011650:Pulmonary Alveoli / Q000378:metabolism; D000077149:Sevoflurane; D013696:Temperature; D055548:Vapor Pressure
chemical_list: D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D000077335:Desflurane; D007530:Isoflurane