The Influence of Two Different CO2 Absorbers on Sevoflurane Consumption During Anaesthesia

Completed

• Conditions: Anesthesia
• Interventions: Other: Comparing two CO2 absorbers in the ventilator circuit

• Registration Number: NCT04271462
• Lead Sponsor: Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)

Brief Summary

Traditional sodalime CO2 absorbers are known to not only react with CO2 but also with sevoflurane. Therewith, a potentially harmful compound (compound A) is formed that can be nephrotoxic. In the United States, the sevoflurane manufacturer therefore recommends keeping the FGF (FGF) at \>2.0 L min-1 if a sodalime CO2 absorbent is used. Amsorb Plus® (Datex-Ohmeda Inc., Madison, WI, USA), is a novel type of CO2 absorbent that does not react with sevoflurane. This allows the FGF to be reduced to 0.5 L min-1. This has two important advantages: (i) less fresh sevoflurane is added to the circle system, and (ii) the sevoflurane that is in the system does not react with the CO2 absorber.

Sevoflurane is a potent greenhouse gas with a 100 year CO2-equivalents of 120. Measures that can reduce the consumption of volatile anaesthetics could make a significant contribution to reducing the carbon footprint of the operative process. Additionally, Amsorb Plus® canisters seem to have a longer life span than sodalime canisters and do not need to be disposed of via toxic waste stream, but via domestic waste.

In this study, we were interested if (i) the use of Amsorb Plus leads to a reduction in sevoflurane usage and therefore contribute to a reduction in the CO2 footprint of general anaesthesia with sevoflurane, (ii) Does the use of Amsorb Plus® lead to a reduction in the amount of (toxic) waste produced by operating theatres?

Comparator: a traditional sodalime CO2 absorber (Medisorb™ Multi-Absorber Original, CareFusion, Helsinki, Finland).

Detailed Description

Not available

Study Timeline

• Study Start: 2020-02-12
• Study First Submitted: 2020-02-13
• Study First Submitted QC: 2020-02-14
• Study First Posted: 2020-02-17
• Primary Completion: 2020-05-29
• Study Completion: 2020-05-29
• Status Verified: 2021-02
• Last Update Submitted: 2021-02-10
• Last Update Posted: 2021-02-11

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 38

Inclusion Criteria

Not provided

Exclusion Criteria

• Unable/ unwilling to participate
• ASA-IV or higher
• Age < 18 years
• Known pregnancy
• Contra-indications for sevoflurane anaesthesia
• Emergency surgery
• Scheduled operating time <2 hours.

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Study group	Comparing two CO2 absorbers in the ventilator circuit	Patients undergoing surgery (\>120 min) with the use of sevoflurane based general anaesthesia (in 1.0 MAC concentration).

Primary Outcome Measures

Name	Time	Method
Influence of CO2 filters on Sevoflurane consumption	30 minutes per filter	Comparing Sevoflurane consumption between Amsorb Plus and sodalime CO2 absorbers

Secondary Outcome Measures

Name	Time	Method
Influence of fresh gas flow on Sevoflurane consumption	30 minutes per fresh gas flow setting	Comparing Sevoflurane consumption between 0.5 and 2.0 liters per minute fresh gas flow

Trial Locations

Locations (1)

Amsterdam UMC, location AMC; 🇳🇱 Amsterdam, Noord-Holland, Netherlands