Clinical trial NCT04271462: The Influence of Two Different CO2 Absorbers on Sevoflurane Consumption During Anaesthesia
Official title: The Influence of Two Different CO2 Absorbers on Sevoflurane Consumption During Anaesthesia
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Anesthesia
Lead sponsor: Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)
Sponsor class: OTHER
First posted: 2020-02-17
Enrollment: 38
Sex: ALL
Minimum age (years): 18
Maximum age (years): 100
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: CASE_CROSSOVER
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patients undergoing general anesthesia with sevoflurane for \> 2 hours.

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).


Eligibility criteria: Inclusion criteria:

* Adult patient
* non-pregnant
* ASA-I to ASA-III
* undergoing Sevoflurane based general anaesthesia (in a therapeutic concentration of 1.0 MAC)
* Elective surgery
* Scheduled operating time \>2 hours.

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.

Primary outcomes:
measure: Influence of CO2 filters on Sevoflurane consumption
timeFrame: 30 minutes per filter
Secondary outcomes:
measure: Influence of fresh gas flow on Sevoflurane consumption
timeFrame: 30 minutes per fresh gas flow setting
Other outcomes:
measure: Estimated CO2 footprint and environmental impact of general anaesthesia with two different CO2 filters
timeFrame: 30 minutes
measure: Estimated cost of general anaesthesia with two different CO2 filters
timeFrame: 30 minutes
measure: Estimated CO2 footprint and environmental impact of general anaesthesia with two fresh gas flow settings
timeFrame: 30 minutes
measure: Estimated cost of general anaesthesia with two fresh gas flow settings
timeFrame: 30 minutes
Locations:
city: Amsterdam
country: Netherlands
facility: Amsterdam UMC, location AMC
state: Noord-Holland
Study officials:
References: