Revista de Métodos de Diagnóstico Médico
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Sedation with Inhaled Anaesthetics in Intensive Care Units: Intravenous Route is not the Only Way

Toledo-Medina C, Rodriguez-Capit?n M, Guerrero-Orriach Jose L, Ramirez-Fernandez A, Malo-Manso A, Escalona-Belmonte J, Rubio Navarro M and Cruz Ma?as J

The action and side effects of intravenous anesthetics are difficult to control in critical patients. The inhaled anaesthetic agents are, at the moment, an alternative to intravenous drugs for sedation in these patients. The Anesthetic Conserving Device (AnaConDa®) facilitates the use of volatile anesthetics in critical care units as part of prolonged sedation. This device (AnaConDa®) is a vaporizer that is integrated into the respiratory circuit, between the -piece and the patient. It consists of a heat-moisture exchanger filter. The volatile anaesthetic gas is applied continuously in liquid form using a syringe pump. During inspiration, the volatile substance is released via the evaporator and transported in such a way to the patient. During the expiration phase, the anaesthetic is exhaled by the patient and is stored in the carbon layer, followed by a rerelease into the gas mixture during the next inspiratory cycle. More than 90% of the anaesthetic gas is recirculated in such a way. 10% of the anaesthetic agent passes through the filter and is released outside through the fan expiratory outlet. The use of volatile anesthetics in critical patients could adopt a permanent position in various intensive care analog sedation concepts in future.