A narrative review of gas separation and conservation technologies during xenon anesthesia

McGuigan, Steven1,2,*; Abrahams, Brendan F.3; Scott, David A.1,2

¹Department of Anesthesia and Acute Pain Medicine, St. Vincent’s Hospital Melbourne, Melbourne, Australia²Department of Critical Care, University of Melbourne, Melbourne, Australia³School of Chemistry, University of Melbourne, Melbourne, Australia

Abstract

Xenon gas has significant advantages over conventional general anesthetic agents but its use has been limited by the cost associated with its production. Xenon also has significant potential for medical use in the treatment of acquired brain injuries and for mental health disorders. As the demand for xenon gas from other industries increases, the costs associated with its medical use are only likely to increase. One solution to mitigate the significant cost of xenon use in research or medical care is the conservation of xenon gas. During delivery of xenon anesthesia, this can be achieved either by separating xenon from the other gases within the anesthetic circuit, conserving xenon and allowing other gases to be excluded from the circuit, or by selectively recapturing xenon utilized during the anesthetic episode at the conclusion of the case. Several technologies, including the pressurization and cooling of gas mixtures, the utilization of gas selective membranes and the utilization of gas selective adsorbents have been described in the literature for this purpose. These techniques are described in this narrative review along with important clinical context that informs how these technologies might be best applied. Whilst these technologies are discussed in the context of xenon general anesthesia, they could be applied in the delivery of xenon gas inhalation for other therapeutic purposes.

摘要：与传统的全身麻醉剂相比，氙气存在明显的优势，但其使用受到与生产成本的限制。氙气在治疗后天性脑损伤和精神障碍方面也具有巨大的医学应用潜力。随着其他行业对氙气的需求增加，其医疗成本还会增加。降低氙气在研究或医疗使用的成本的一种方法是氙气保存。在氙气麻醉的输送过程中，可通过将氙气与麻醉回路内的其他气体分离、保存氙气并允许其他气体从回路中分离来实现，也可通过在麻醉结束时选择性回收氙气来实现。为此，此次综述总结了在氙气麻醉中保存氙气的方法麻醉气体混合物的加压和冷却、气体选择性膜以及气体选择性吸附剂，同时还介绍了如何应用这些技术的临床背景。虽然这些技术是在氙气全身麻醉的背景下讨论的，但它们也可以应用于氙气吸入的其他治疗目的。