A technique to depress desflurane vapor pressure

Objective: To determine whether the vapor pressure of desflurane could be decreased by using a solvent to reduce the anesthetic molar fraction in a solution (Raoult's Law). We hypothesized that such an anesthetic mixture could produce anesthesia using a nonprecision vaporizer instead of an agent-specific, electronically controlled, temperature and pressure compensated vaporizer currently required for desflurane administration. Animal: One healthy adult female dog. Procedure and results: Propylene glycol was used as a solvent for desflurane, and the physical characteristics of this mixture were evaluated at various molar concentrations and temperatures. Using a circle system with a breathing bag attached at the patient end and a mechanical ventilator to simulate respiration, an in-circuit, nonprecision vaporizer containing 40% desflurane and 60% propylene glycol achieved an 11.5% ± 1.0% circuit desflurane concentration with a 5.2 ± 0.4 (0 = off, 10 = maximum) vaporizer setting. This experiment was repeated with a dog attached to the breathing circuit under spontaneous ventilation with a fresh gas flow of 0.5 L minute^-1. Anesthesia was maintained for over 2 hours at a mean vaporizer setting of 6.2 ± 0.4, yielding mean inspired and end-tidal desflurane concentrations of 8.7% ± 0.5% and 7.9% ± 0.7%, respectively. Conclusions and clinical relevance: Rather than alter physical properties of vaporizers to suit a particular anesthetic agent, this study demonstrates that it is also possible to alter physical properties of anesthetic agents to suit a particular vaporizer. However, propylene glycol may not prove an ideal solvent for desflurane because of its instability in solution and substantial-positive deviation from Raoult's Law.