Medical College of Wisconsin
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Interaction of inhalational anaesthetics with CO2 absorbents. Best Pract Res Clin Anaesthesiol 2003 Mar;17(1):63-76



Pubmed ID




Scopus ID

2-s2.0-0038387345 (requires institutional sign-in at Scopus site)   22 Citations


We review the currently available carbon dioxide absorbents: sodium hydroxide lime (=soda lime), barium hydroxide lime, potassium-hydroxide-free soda lime, calcium hydroxide lime and non-caustic lime. In general, all of these carbon dioxide absorbents are liable to react with inhalational anaesthetics. However, there is a decreasing reactivity of the different absorbents with inhalational anaesthetics: barium hydroxide lime >> soda lime > potassium-hydroxide-free soda lime > calcium hydroxide lime and non-caustic lime. Gaseous compounds generated by the reaction of the anaesthetics with desiccated absorbents are those that threaten patients. All measures are comprehensively described to--as far as possible--prevent any accidental drying out of the absorbent. Whether or not compound A, a gaseous compound formed by the reaction of sevoflurane with normally hydrated absorbents, is still a matter of concern is discussed. Even after very high loading with this compound, during long-lasting low-flow sevoflurane anaesthesias, no clinical or laboratory signs of renal impairment were observed in any of the surgical patients. Finally, guidelines for the judicious use of different absorbents are given.

Author List

Baum JA, Woehlck HJ


Harvey J. Woehlck MD Professor in the Anesthesiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Anesthetics, Inhalation
Barium Compounds
Calcium Compounds
Calcium Hydroxide
Carbon Dioxide
Methyl Ethers
Potassium Compounds
Sodium Hydroxide