SciELO - Scientific Electronic Library Online

 
vol.46 issue3Unexpected difficult airway management due to the use of ACE inhibitors: case reportQuestions and answers author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand

Journal

Article

Indicators

Related links

  • On index processCited by Google
  • Have no similar articlesSimilars in SciELO
  • On index processSimilars in Google

Share


Colombian Journal of Anestesiology

Print version ISSN 0120-3347

Rev. colomb. anestesiol. vol.46 no.3 Bogotá July/Sept. 2018

https://doi.org/10.1097/cj9.0000000000000060 

Letter to the Editor

Desflurane yellowing

Manuel Jesús Rico-Borregoa  * 

Enrique Melguizo-Madridb 

Ignacio Jiménez-Lópeza 

Rafael Rubio-Romeroa 

Ignacio Jiménez-Lópeza 

a Anaesthesiology and Resuscitation, Hospital Universitario Virgen del Rocío, Sevilla, España

b Hospital Universitario Virgen Macarena, Sevilla, España


During the intervention, when refilling the desflurane vaporizer, we observed that the product was no longer clear (Fig. 1A). The vaporizer was removed from the anaesthesia circuit and after 1hour of observation, a supernatant was found to cover the wall of the level monitor (Fig. 1B). This discolaration, reported in the literature,1-3 is due to the accumulation of oxidized by-products of butylate hydroxytoluene (BHT) (E-321) (2,6-bis(1,1-dimethylethyl)-4-methylphenol, C15H24O, P. M.: 220.35) (Fig. 2) an antioxidant present in the elastomer used to seal desflurane bottles,1,3 authorized for use in the food industry.

Source: Authors.

Figure 1 Desflurane yellowed. Initial appearance and appearance after one hour at rest. 

Source: Authors.

Figure 2 BHT oxidado en radicales resonantes-quinonas (coloreados). BHT=butylate hydroxytoluene. 

Desflurane must be stored at a temperature of 15 to 30 °C. The probability of yellowing is higher when this temperature is exceeded. BHT and its by-products have higher boiling points than desflurane and remain trapped in the vaporizer sink and do not flow into the gas circuit. They are not associated with deleterious effects for the patients, although the contamination made evident by BHT oxidation creates interactions of unpredictable consequences. We believe it is important to be aware of this discoloration phenomenon and prevent its occurrence.

References

1. Kim DJ, Jung KT. The yellow discoloration of desflurane. Korean J Anesthesiol 2017;70:224-225. [ Links ]

2. Lawrence Schulte S, Ellis S. Discolored desflurane in the vaporizer. Anesth Analg 2010;110:644-645. [ Links ]

3. Baluja S, Bhesaniya K, Bhalodia R, et al. Solubility of butylated hydroxytoluene (BHT) in aqueous and alcohol solutions from 293.15 to 313.15. Int Lett Chem Phys Astron 2014;9:48-58. [ Links ]

How to cite this article: Rico-Borrego MJ, Melguizo-Madrid E, Lozano-Guijarro Y, Rubio-Romero R, Jiménez-López I. Desflurane yellowing. Rev Colomb Anestesio! 2018;46:266-267.

Funding The authors did not receive any sponsorship to produce this article.

Conflicts of interest The authors have no conflicts of interest to declare.

* Correspondence: Anaesthesiology and Resuscitation, Hospital Universitario Virgen del Rocío, Avda, Manuel Siurot s/n, CP 41013 Sevilla, España. E-mail: mj_rico@hotmail.com

Creative Commons License This is an open-access article distributed under the terms of the Creative Commons Attribution License