Why is my anaesthesia machine detecting halothane after bronchodilator administration? A curious fact

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Un dato curioso" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1226 "Ancho" => 2091 "Tamanyo" => 302012 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Screen of Dräger Primus® anaesthesia machine showing the “2 mixed agents” alarm and the presence of two anaesthetic gases in the gas analyser: desflurane, which is the anaesthetic agent being administered, and halothane, which is produced by the salbutamol inhaler." ] ] ] "textoCompleto" => "It is common practice to administer a few puffs of salbutamol or ipratropium inhaler via the orotracheal tube to treat episodes of bronchospasm during general anaesthesia. Following this, most anaesthesiologists will have noticed that their anaesthesia gas analyser detects the presence of halothane (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>), even though this volatile anaesthetic was not administered and is probably not even available in their hospital.<elsevierMultimedia ident="fig0005"></elsevierMultimedia>Salbutamol and ipratropium have very little structural resemblance to halothane, and when salbutamol is administered by nebulization, no halothane is detected. Why, then, is it detected when administered by inhaler? The answer lies in the inhaler itself, which contains HFA 134a (hydrofluoroalkane 1,1,1,2-tetrafluoroethane) a propellent with a structure that is very similar to halothane and is the cause of the interference. Curiously enough, HFA 134a was studied in the 1960s as an inhaled anaesthetic because of its moderately potent anaesthetic effects.FundingThis research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.Conflicts of interestThe authors have no conflict of interest to declare." 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Revista Española de Anestesiología y Reanimación (REDAR) -the Spanish Journal of Anesthesiology and Resuscitation- is the scientific body of the Spanish Society of Anesthesiology, Resuscitation and Pain Therapy. This is a monthly journal (10 issues) that publishes scientific articles of all areas within its specialty: clinical anesthesia, resuscitation-intensive medicine and critical care, diagnosis and treatment of acute and chronic pain, urgent care and emergencies and studies on basic science and related fields. The journal accepts work in both Spanish and English.

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