ANESTHETIC UPTAKE AND WASHOUT CHARACTERISTICS OF PATIENT CIRCUIT TUBING WITH SPECIAL REGARD TO CURRENT DECONTAMINATION TECHNIQUES

The amounts of halothane and isoflurane trapped after exposure for up to 3 h at 2 MAC in commonly used anaesthesia circuit tubing were quantitated by gas chromatography. The decontaminating effects of procedures such as flushing with oxygen, thermal disinfection and/or routine storage were assessed in a similar way. After halothane exposure, anaesthetic content was highest in silicone (398 +/- 55 mg 100 g-1). Lower quantities were found in all other tubings investigated (electrically conductive latex: 64 +/- 4, conductive rubber: 62 +/- 4, polyethylene-vinyl-acetate (PEVA): 293 +/- 10 and 149 +/- 17 for non-conductive corrugated and spiral tubes, respectively, polysulfone (Hytrel(R): 155 +/- 10 mg 100 g-1). The isoflurane contents were substantially lower (silicone: 278 +/- 23: others: 55 +/- 7, 61 +/- 6, 163 +/- 9 and 86 +/- 8, 74 +/- 4 mg 100 g-1). The tubings' content did not correlate with the material's partition coefficient as full saturation was not achieved during exposure. Decontamination procedures reduced the content of volatile anaesthetics to a variable extent. Conductive latex and rubber showed the highest residual content, even after thermal disinfection and subsequent storage. Twenty-minute flushing with oxygen (8 l min-1) decreased effluent gas concentrations below 5 p.p.m. in all tubings. With silicone, after 1 h flushing, halothane concentrations still exceeded 10 p.p.m. (isoflurane: 8 p.p.m.). It is concluded that urgent decontamination by a 20-min flush warrants the safe re-use of previously 'contaminated' conductive rubber and latex as well as polysulfone tubings in critical situations, e.g. in malignant hyperthermia patients if disposable tubing is not immediately available. In contrast, we warn against re-using silicone and disposable PEVA tubing because of high uptake and considerable release during desorption.