Anaes · Vaporisers
Vaporisers
Also known as Vaporiser · Plenum vaporiser · Variable-bypass · Draw-over vaporiser · Desflurane vaporiser · Temperature compensation
The vaporiser vaporises the liquid volatile anaesthetic agent and adds a precise concentration to the fresh gas flow. The framework rests on four exam-critical ideas: the variable-bypass plenum vaporiser, where the dial sets the splitting ratio between chamber and bypass flow (Dhulkhed 2013; Abel 1996); the temperature compensation by bimetallic strip and bellows as vaporisation cools the liquid and its saturated vapour pressure falls (Dhulkhed 2013); the desflurane exception — its remarkably high vapour pressure means it is not a variable-bypass system but an electrically heated, pressurised, dual-circuit blender (Miller 1994; Andrews 1993); and the safety systems of agent-specific calibration, keyed fillers and the single-vaporiser interlock (Abel 1996; Dhulkhed 2013). Checked per the AAGBI guidelines (2012) and the machine-check assessment (Tiviraj 2016), with low-flow conservation per the closed-circuit review (Parthasarathy 2013).
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Red flags
- Desflurane has a remarkably high vapour pressure — near atmospheric, boiling near room temperature. A standard variable-bypass vaporiser could let it boil and deliver a dangerously high concentration. Desflurane MUST use a heated, pressurised vaporiser.
Meet the patient
You are checking the anaesthetic machine at the start of a list when a new registrar asks why the desflurane vaporiser lives in its own heated box and needs a power lead. The answer is one physical fact — desflurane's remarkably high vapour pressure — and that fact is the difference between a safe induction and a lethal one.[5]
Hold two questions and every vaporiser viva falls into place: how does the dial control the concentration? (the splitting ratio) and why does desflurane need a different machine? (its vapour pressure is near atmospheric). Everything below is a refinement of those two.[4][5]
References8ShowHide
- [1]Hartle A, Anderson E, Bythell V, et al. Checking anaesthetic equipment 2012: association of anaesthetists of Great Britain and Ireland Anaesthesia, 2012.PMID 22563957
- [2]Tiviraj S, et al. Development of An Assessment Test for An Anesthetic Machine J Med Assoc Thai, 2016.PMID 27501622
- [3]Parthasarathy S The closed circuit and the low flow systems Indian J Anaesth, 2013.PMID 24249885
- [4]Dhulkhed V, et al. Vapourisers: physical principles and classification. Indian J Anaesth, 2013.PMID 24249878
- [5]Miller D The Tec 6 vaporizer: why desflurane needs to be heated. AANA J, 1994.PMID 7879584
- [6]Andrews JJ, et al. The new Tec6 desflurane vaporizer. Anesth Analg, 1993.PMID 8498675
- [7]Abel M, et al. Performance of erroneously filled sevoflurane, enflurane and other agent-specific vaporizers. J Clin Monit, 1996.PMID 8823632
- [8]Graham SG New drug in volatile anaesthesia--desflurane. Ann Acad Med Singap, 1994.PMID 7979126