[Mass-spectrometric control of compound A during minimal flow anesthesia and its influence on liver and kidneys functions].

The article contains results of mass-spectrometric control of sevoflurane and compound A concentrations during inhalation anesthesia with minimal flow (< or = 0.5 l/min) and its influence on liver and kidney function. 40 patients (ASA I-II) were included in the study. Transsphenoidal pituitary adenomectomy was performed in all cases. Patients didn't have any signs of liver or kidneys disfunctions preoperatively. We used quadrupole mass spectrometer "Prisma Plus" (Pfeiffer vacuum, Germany) to determine the real time concentration of sevoflurane and compound A. Intensity of m/z = 131 peak sevoflurane and m/z = 128 peak compound A were registered. Laboratory blood tests to assess liver and kidney function were carried out before anesthesia, after anesthesia, and on the 1st day after anesthesia. They included: AST, ALT, total bilirubin, total protein, urea, creatinine. Quantitative analysis of the compound A and blood test before and after anesthesia showed only a tendency to increase biochemical markers levels within normal range, except small, but significant, AST elevation and total protein reduction in postoperative period. We concluded that maximal registered level of compound A (275 ppm/h) during minimal flow anesthesia didn't associate with significant liver and kidneys injury in healthy patients.

Mass-spectrometric monitoring of anesthesia adequacy.

Anesthesia adequacy was assessed with mass-spectrometric method by monitoring the ratio of mass concentrations of end-tidal CO2 and inhaled O2 in every respiratory cycle during surgery. For real-time monitoring, we used a mass spectrometer with electron ionization connected to the respiratory contour of inhalation anesthesia machine. The study has demonstrated advantages of the novel method in real-time assessment of adequacy of the total intravenous anesthesia.