Brit. J. Anaesth.

(1968), 40, 648

THE DESIGN AND CALIBRATION OF VAPORIZERS

FOR VOLATILE ANAESTHETIC AGENTS
BY

D. W. HILL

The saturated vapour pressure of most volatile vapour pressure of halothane is 243 torr at 20° C.
anaesthetic agents is generally much greater than From a knowledge of the s.v.p. of a particular
the partial pressure in the inspired gases required agent over the required temperature range, it is
to produce clinical anaesthesia. The function of now possible to arrange to systematically dilute
an anaesthetic vaporizer is to bring about dilu- the saturated vapour to levels commensurate with
tion of the saturated carrier gas in a controlled clinical administration.
fashion which is reasonably independent of both When a gas stream is passed through the vapor-
changes in the ambient temperature and the izing chamber in order to remove the saturated
volume flow of gas perfusing the vaporizer. vapour, it will sweep away the most energetic
molecules, since these are the ones that will have
THE VARIATION OF THE SATURATED VAPOUR overcome the inwardly-directed attractive forces
PRESSURE WITH TEMPERATURE present at the liquid-vapour interface. As a result
When a liquid is in contact with its vapour inside the mean energy, and hence the temperature, of
a closed container, a state of equilibrium is at- the liquid falls as evaporation proceeds.
tained in which as many molecules leave the
liquid by evaporation per second to escape into PLENUM VAPORIZERS
the vapour phase as rejoin the bulk liquid per The usual models of vaporizers found on anaes-
second. Under these conditions, the vapour above thetic machines are of the plenum type which is
the liquid is said to be fully saturated, and this is perfused with fresh gas from the machine. The
the condition that is obtained in the vaporizing term is derived from the plenum system of venti-
chamber of a calibrated vaporizer. The vapour lation in which gas is forced into the system. The
molecules bombard the walls of the vessel and vaporizer (fig. 1) consists basically of a vaporiza-
give rise to a definite pressure, known as the tion chamber which is perfused with a fraction
Saturated Vapour Pressure, s.v.p. It is important of the fresh gas flow and adds to this a proportion
to remember that the s.v.p. depends only upon of anaesthetic vapour. At low chamber flows, care
the nature of thi liquid and its temperature, it must be taken to ensure that the gas picks up
does not, within the range of pressures encoun- sufficient of the vapour, particularly in the case
tered in anaesthesia, depend upon the barometric of a heavy vapour such as halothane. The larger
pressure. This fact is important in discussing the fraction of the fresh gas flow is then added to the
functioning of anaesthetic vaporizers under
hyperbaric conditions. Bypass
For a given volatile anaesthetic agent, the graph Gas
of s.v.p. (P) against ambient temperature (t) is a in —
smooth curve. An equation can be fitted to each
curve, those for diethyl ether and halothane
being:
Ether: log10P=6.78574 - (994.195)/(t +22.0)
Halothane: Vaporizing
log, 0 P=6.8468 - (1079.74)/(f + 222.06) chamber
In these equations, the s.v.p. (P) is given in torr*
and the temperature t in "C. The saturation
FIG. 1
' T o all intents and purposes 1 torr=l mm Hg. Simple plenum vaporizer.
DESIGN AND CALIBRATION OF VAPORIZERS FOR VOLATILE AGENTS
output from the vaporizing chamber in order to
dilute the issuing vapour to the required clinical
concentration.
The Boyle bottle vaporizer.
The simplest type of plenum vaporizer is seen
in the well-known Boyle bottle vaporizer. A cyl-
indrical tap splits the gas into bypass and vapor-
izing chamber flows. Movement of a plunger
allows the distance between the port delivering
gas into the chamber and the surface of the liquid
anaesthetic to be varied. The vaporizing chamber
is a simple glass bottle which does not contain
any wicks. The variation oi the output from an
ether Boyle bottle with the setting of the tap
control lever and the position of the plunger has
been discussed by Macintosh, Mushin and Ep-
stein (1958). Stability of the output of a vaporizer
with time really means stability with regard to a
fall in temperature of the vaporizing liquid. Since
glass is a poor conductor of heat, there is insuffi-
cient inflow of heat to hold the temperature of the
liquid constant. As the temperature falls, so the
output concentration decreases significantly with
time. Halothane is not so volatile as ether (its
saturated vapour pressure is approximately one-
third of an atmosphere compared with one-half
for ether). Thus cooling problems are not so
serious for halothane vaporizers. Since lower con-
centrations are required for halothane than for
ether, the halothane Boyle bottle uses only the
control tap and has no moving plunger, the gas
entering the bottle from fixed holes in the inlet
pipe, above the surface of the halothane. A simple
glass bottle holding the liquid agent does not
always produce fully saturated vapour, so that the
calibration from this type of vaporizer is not re-
producible. In addition, when the vaporizer has
been standing for some time, a considerable vol-
ume of vapour builds up above the liquid. This
gives rise to a significant "surge" of vapour when
the vaporizer is first turned on (Jennings and
Hersant, 1965). A surge ot vapour may also be
delivered if the vaporizer is shaken. Seed (1967)
describes a baffle device fitted into the bottle of a
Boyle halothane vaporizer to prevent agitation
of the halothane when the anaesthetic machine is
moved.
These deficiencies have led to the development
of a number of more sophisticated, although more
649
expensive, vaporizers usually having wicks and
some means of compensating for the fall in tem-
perature occurring as the liquid vaporizes. How-
ever, for the low rates encountered in small
animal anaesthesia the cooling effect is minimal
Parbrook (1966) describes an all-glass simple by-
pass vaporizer for such applications.
IMPROVED PLENUM VAPORIZERS
Pearce (1962) describes a version of the Boyle
halothane vaporizer in which the temperature of
the halothane is measured by a small bimetallic
strip type of thermometer. A chart is provided in
the model sold by the Loosco Company of Am-
sterdam so that the correct tap setting can be
chosen to give the required halothane concentra-
tion for a given gas flow and temperature. But, of
course, the tap requires resetting if vaporization
lowers the temperature of the liquid halothane.
Although a degree of manual temperature com-
pensation is provided in this system, the design of
the tap will not hold constant over a wide range of
flow rates the ratio of flow split between the cham-
ber and bypass. This is achieved in the Drager
"Vapor" range of vaporizers by means of using
two special conical taps, one to control the bypass
and the other to control the chamber flow (fig. 2).
The body of the vaporizer is made from a heavy
block of copper having a high thermal capacity.
This acts as a reservoir of heat and helps to hold
the temperature of the halothane constant. The
actual temperature of the halothane is read from a
built-in mercury-in-glass thermometer. The dial
used for setting the concentration of halothane de-
livered by the vaporizer carries a number of scales
each corresponding to a particular concentration.
In use the dial is rotated until the required con-
centration scale intersects a fixed temperature
scale at the temperature shown on the thermo-
meter. The opening of the bypass valve is pre-set
by the manufacturer, the chamber valve acting
as the concentration control. Each cone consists
of a male and a female cone, the ratio of the
length of a cone to its gap being of the order of
100:1; filters are provided to prevent the ingress
of grit into the valves. The pressure drop across
each valve is linearly related to the volume flow
of gas through it, both in the forward and reverse
directions. As a result, the flow-splitting ratio is
little changed over the fresh gas flow range of
650
FIG. 2
Cross-section of a Drager "Vapor" vaporizer.
100 ml to 10 L/min. The vaporizing chamber
contains wicks. The Vapor vaporizers are the
most accurate yet made, and they are extremely
useful in the laboratory as sources of accurate
concentrations of anaesthetic vapours (Hill, 1963).
However, thty are very heavy and tend to be
expensive, although since they can be operated
outside a circle with low fresh gas flow rates, they
can provide a considerable saving in the cost of
halothane. A pressure relief valve is fitted to the
vaporizing chamber in order to prevent any build-
up of vapour pressure.
The need for a manual adjustment to compen-
sate for temperature changes of the liquid can be
eliminated by the use of a temperature-sensitive
valve, but at the expense of making the output
concentration dependent upon the perfusing gas
flow rate at the lower flows.
Automatic temperature compensation is used
in the well-known Fluotec vaporizer (fig. 3)
BRITISH JOURNAL OF ANAESTHESIA
(Mackay, 1957; Brennan, 1957). The concentra-
tion control adjusts the splitting ratio between the
chamber and bypass flows. The gas going into
the chamber passes over a series of wicks in order
to ensure that it emerges fully saturated. The out-
let port from the chamber is controlled by a
bimetallic strip valve. As evaporation proceeds
and the temperature of the halothane falls so the
Gas inlet
Gas outlet
Spring
FIG. 3
Cross-section of a Fluotec vaporizer.
strip bends back, opening the valve and allowing
more vapour to emerge in order to hold the out-
put concentration from the vaporizer reasonably
constant The output is independent of flow rate
above 4 L/min (fig. 4). At lower flow rates, the
output rises to a peak at about 1 l./min due to
non-linearity of the flow-splitting ratio, and falls
to zero if the fresh gas flow is reduced to 500
ml/min. There is then insufficient pressure drop
developed across the bypass to force enough gas
through the vaporizing chamber. A calibration
card for use at flow rates below 4 l./min is pro-
vided with each instrument. A vaporizer employ-
ing similar principles is the MIE. "Halothane 4".
This employs a mercury-expansion type of ther-
mal compensation device and does not exhibit a
peak in its calibration curve like the Fluotec.
Massa and Zander (1964) found that the Halo-
thane 4 vaporizer gave output concentrations
lower than the calibration would indicate.
DESIGN AND CALIBRATION OF VAPORIZERS FOR VOLATILE AGENTS 651

to the outlet (3). The vaporizing chamber stream

flows through the wicks and chamber which has a
small gas volume and emerges through the vari-
6 v able control valve (4) which is in series with a
fixed restriction (5), to merge with the bypass
% 5
n\ — flow. The relief valve (6) limits the pressure of the
inlet gas if high flows are applied to the vaporizer.
I* The control needle valve (4) has a relatively large
i. needle made from a plastic material which has a

1
»* 3
a the valve seating. As the temperature of the
2 2
— • 1 ~n
Q the flow in such a way as to hold the output
0 1 2 3 4 5 6 7 8
Flow rate, litres per minute
FIG. 4
Calibration curve for a Mark 2 Fluotec vaporizer.
The problem of holding the calibration of a
vaporizer reasonably constant with changing flow
rates when an automatic temperature compensa-
tion system is employed has been tackled in an
ingenious fashion in the New Forreger "Fluo-
matic" halothane vaporizer. A sectional diagram
of the Fluomatic in the ON position is given in
figure 5. The fresh gas flowing into the vaporizer
at (1) is divided in the usual way, the bypass
stream passing through the fixed restriction (2)
FIG. 5
Cross-section of a Fluomatic vaporizer in the "ON"
position.
B
high coefficient of thermal expansion relative to
emerging gas and vapour stream from the cham-
ber alters, so the valve opens or closes to adjust
concentration constant. A similar arrangement
operates with the fixed restriction (5) in series
with the control valve. The advantage of this
arrangement is that no additional moving parts
are needed. Figures 6 and 7 show the perfor-
mance of the Fluomatic under conditions of vary-
ing temperature and flow rate.
The lower saturated vapour pressure of meth-
oxyflurane means that a vaporizer for this sub-
stance must pass more of the fresh gas through
the vaporizing chamber than would occur for
vaporizers designed to work with other agents.
Figure 8 shows a section of the Forreger "Pento-
matic" vaporizer. The upper section (2) of the
control valve controls the bypass flow, whilst the
lower section (4) controls the outlet from the
vaporizing chamber. The two sections move up
or down as a unit when the concentration setting
dial (5) is adjusted. The valves provide automatic
temperature compensation as described for the
Fluomatic vaporizer. The isolation valve (7) is
moved through a linkage to the control knob (5)
to close both the inlet and outlet of the vaporiz-
ing chamber (fig. 9). A low-resistance bypass
channel completely bypasses the vaporizing
chamber, and the chamber is vented to atmos-
phere at (8). The pressure applied to the vapor-
izer is limited by the relief valve (6).
The mode of operation of plenum vaporizers
can be clearly seen in the following calculation.
Suppose that the vaporizer is required to produce
a 1 per cent v/v concentration of halothane in a
total minute volume (gas+vapour) of 6 L If the
ambient temperature is 22°C, the saturation con-
centration of halothane in the vaporizing cham-
ber is 35.5 per cent v/v. To produce the required
652 BRITISH JOURNAL OF ANAESTHESIA

5.0
U- —r- =.

«.o
O
50
FIG. 6
30
3 - • The variation of the output
from a Fluomatdc vaporizer
5 20 with temperature at a constant
< 20 < flow rate of 5 \./m.
X a
1 0
-

IT
TEMPERATURE

FIG. 7
O
«o ci The variation of the output
Co from a Fluomatk vaporizer
O with gas flow readings taken
__ at 70 °F after successive
< 5-minute runs at each flow for
Q each dial setting.

5 4
FLOW LITERS PER MINUTE

FIG. 8 FIG. 9
Cross-section of a Pentomatic vaporizer in the Cross-section of a Pentomatic vaporizer in the
"ON" position. "OFF" position.
DESIGN AND CALIBRATION OF VAPORIZERS FOR VOLATILE AGENTS 653

1 per cent v/v concentration, 1 part of the satur-

ated vapour must be added to 34.5 parts of fresh
gas. Thus, of the total volume flow of 6000 ml,
170 ml must emerge from the vaporizing cham-
ber, and 5830 ml of gas must pass through the
bypass per minute. Of the 170 ml, 35.5 per cent
is halothane vapour, i.e. 60 ml of halothane
vapour. This corresponds to the vaporization of
0.26 ml of liquid halothane per minute The gas
flow into the vaporizing chamber is (170-60)
= 110 ml/min.
In the case of the temperature-compensated
vaporizers so far described, it has not been re-
quired to measure separately the bypass and
vaporizing chamber flows. However, if these are
both known, together with the temperature of the
liquid, and the vaporizing chamber delivers satur-
ated vapour, then both the output concentration
and the mass of agent delivered per minute can
be calculated. This principle is used in the well-
known Forreger "Copper Kettle" vaporizer
(Morris, 1952), in which the vaporizing cham-
ber is constructed of copper and is fixed to a
copper plate on the anaesthetic machine. This
provides a good reservoir of heat when ether is
used. Figure 10 shows the Copper Kettle vapori-
zer in section. The flow of oxygen enters the FIG. 10
vaporizer through tube (1) and surge chamber (2). Cross-section of a Copper Kettle
It leaves the chamber via the concentric tube (3) vaporizer.
which leads into the annular chamber (4) of the
sintered bronze disk diffuser (5). The many fine taining 3.1 per cent v/v of halothane, there must
bubbles formed give rise to fully saturated vapour. be a flow of 172 ml/min into the chamber and a
The bubbles rise through the liquid agent (6) and bypass flow of 2250 ml/min if the saturation
pass into the chamber (7) above the liquid, the concentration of halothane is 31.2 per cent at
saturated vapour emerging via the exit tube (8) 20 "C. Calculators are available to help the anaes-
to join the main bypass gas flow stream from the thetist set up the required flows (Collis, 1966;
anaesthetic machine gas flow meters. The kettle Jennings, Taylor and Young, 1967). Martin (1968)
inlet (1) is fed from its own oxygen flow meter. has evaluated the performance of the Halox
A Copper Kettle of 400 ml capacity is normally vaporizer. He finds that at flows greater than 4
used for the vaporization of ether and methoxy- l./min the fall in temperature of the Halox is
flurane, a 160-ml capacity kettle being used with troublesome. In his opinion, under these circum-
halothane (Feldman and Morris, 1958). The stances the Halox offers no advantages over the
British Oxygen "Halox" vaporizer works on simi- Boyle bottle type of halothane vaporizer.
lar principles (Young, 1966), but has an all-glass
construction since it is only intended for use
DRAW-OVER VAPORIZERS OR INHALERS
with halothane An additional oxygen flow meter
fitted to the Boyle anaesthetic machine measures The plenum vaporizers so far described are de-
the oxygen fed through a sintered glass disk to signed to work with the uni-directional gas flows
bubble through the halothane (fig. 11). If it is obtained from anaesthetic machines or gas cylin-
required to produce an output of 2.5 l./min con- ders. Their resistance is too high for use as draw-
over vaporizers where the patient's respiratory
654
FIG. 11
The connection of a Halox vaporizer to the manifold of a Boyle anaesthetic machine.
efforts pull the gas through the vaporizer, and
their calibration would not hold under intermit-
tent flow conditions. The EMO vaporizer was
developed as a calibrated, low-resistance, draw-
over vaporizer for use in underdeveloped coun-
tries and in emergency conditions (Epstein and
Macintosh, 1956; Leatherdale, 1966). The water-
jacket surrounding the vaporizing chamber pro-
vides a reservoir of heat, and a metal bellows
filled with ether vapour acts as a temperature-
compensation valve at the chamber outlet. As the
temperature falls, the bellows contracts and opens
the valve. The calibration of the EMO only holds
for intermittent flows. Stetson (1968) describes a
modification to the EMO vaporizer in order to
prevent sticking of the concentration control knob.
This involves the substitution of a Teflon rotor
in the vaporizer.
The Oxford Miniature Vaporizer (OMV) em-
ploys stainless steel wicks and a water-filled base,
and can be used with halothane, chloroform or
trichloroethylene under continuous or intermit-
tent flow conditions. Its clinical performance for
halothane is discussed by Parkhouse (1966) and
Jensen (1967).
BRITISH JOURNAL OF ANAESTHESIA
Compact draw-over vaporizers lend themselves
to incorporation in portable anaesthetic apparatus.
Stephens (1965) describes the performance of the
Cyprane "Haloxair" anaesthetic apparatus which
incorporates a compact halothane inhaler, and
Hedstrand (1966) describes the AGA "Anestor
Militar" emergency anaesthetic apparatus which
uses the SOCSIL draw-over vaporizer for ether,
halothane or chloroform (Hallen and Norlander,
1966; Martinez, Norlander and Santos, 1966).
The Blease Universal Vaporizer can be used as
a plenum or draw-over vaporizer, and can be
provided with a series of interchangeable control
cams so that it can be used with almost any vola-
tile anaesthetic agent (fig. 12). The pressure drop
across it is 10 mm HjO at a gas flow rate of
30 L/min. It offers the advantage that it can be
used with an anaesthetic machine in order to
familiarize anaesthetists with its characteristics.
It can then be used with confidence by these
anaesthetists under draw-over conditions. A
detailed study of the Blease Universal Vaporizer
is that of Merrifield, Hill and Smith (1967).
Although it performed in a satisfactory manner
for plenum and draw-over conditions, the con-
 DESIGN AND CALIBRATION OF VAPORIZERS FOR VOLATILE AGENTS
Concentration scale
Vapour chamber
inlet valve / Control cam Confrql valve
r / Cam fotlower / Gas oxygen »ir inlet
nuerano Anaesthetic _ / Water jacket
level g'Ss •*"<• Te
"Wature
" sensitive unit
FIG. 12
Cross-sections of the Blcasc Universal vaporizer.
centration fell off rapidly with time when it was
placed inside a circle. This may have been due
to the uptake of water by the wicks. It is a devel-
opment of the former Gardner Universal Vapori-
zer (Dobkin et aL, 1963). Schreiber and Weis
(1965) report inaccuracies present in the calibra-
tion of a Gardner Universal Vaporizer.
THE DSE OF VAPORIZERS WITH CIRCLE
ANAESTHETIC SYSTEMS
A vaporizer can either be placed outside the circle
in the fresh gas supply hie, or it can be placed
inside the circle. In the first case it receives only
the fresh gas flow rate in the form of dry gas. In
the second it receives the patient's expired minute
volume of gas which will be fully saturated with
water vapour. The two conditions are quite differ-
ent, the first requiring a high-efficiency vaporizer
which can deliver a high output concentration at
low flows, the second requiring a low-efficiency
vaporizer which will only add small increments of
vapour to the minute volume recirculating
through i t
A detailed account of the functioning of
vaporizers in circle systems is given by Mapleson
655
Control valve
Temperature
sensitive unit
. J - W a t e r jacket
3
Incoming <jases Anaesthetic
• Saturated vapour agent
- Mixed gases
(1960) and Mushin and Galloon (I960). One ad-
vantage of using a circle system lies in the econ-
omy of consumption of the anaesthetic agent
which is possible at low fresh gas flow rates.
When flows through the vaporizer of 1 L/min or
less are used, attention must be paid to the so-
called "pumping effect" (Hill and Lowe, 1962;
Gordh et al., 1964), unless the vaporizer is de-
signed to eliminate this effect. When intermittent
positive pressure ventilation is employed, the in-
flation pressure is transmitted up the fresh gas
pipe from the drele into the vaporizing chamber
of the vaporizer. During the expiratory phase
when the pressure is released, the contents of the
chamber return to the bypass not only via the
normal exit port of the chamber but via the inlet
port as well. This additional increment of vapour
gives rise to an enhanced outlet concentration.
For example, Hill and Lowe found that at 500
ml/min, the effect of IPPR at 10 breaths per
minute with a 20 cm H 2 O inflation pressure was
to increase the output of a Mark 2 Fluotec vapori-
zer from the 3 per cent v/v set on the dial to
4.1 per cent. If requested to do so, the makers
of the Fluotec can supply a model which has a
616 BRITISH JOURNAL OF ANAESTHESIA

miniature pressure regulator fitted to its outlet
(fig. 13) (Edmondson and Hill, 1962; Kapfham-
FIG. 13
Pressurizing valve fitted to the output of a Fluotec
vaporizer.
mer and Atabas, 1965). This prevents pressure
fluctuations from the circle getting back into the
vaporizer. Another possibility is to fit a uni-
directional valve to the outlet of the vaporizer
(Keenan, 1963). The Drager "Vapor" vaporizer
is fitted with a long inlet tube to the vaporizing
chamber. When the pressure in the vaporizing
chamber due to IPPR is released, the vapour does
not emerge into the bypass from this long tube,
and is forced back into the chamber during the
next inflation (fig. 14). A method tried by Hill
and Lowe (1962) and Lowt et al. (1962) was to
place a needle valve distal to the Fluotec and by
this means raise the pressure in the vaporizer to
40 cm H , 0 which is well above normal inflation
pressures. Keet, Valentine and Riccio (1963) de-
scribe an arrangement designed to prevent pres-
sure effects on the Vernitrol vaporizer.
Two design features Ere claimed to eliminate
the "pumping.effect" in the case of the Forreger

U) (b) (c)

(e) (f)
FIG. 14
(a, b, c.) The release of positive pressure from the vaporizing chamber allows vapour to rejoin
the bypass from the normal inlet to the chamber (d, e, f) this effect is eliminated by the use of
a long inlet pipe to the vaporizing chamber.
DESIGN AND CALIBRATION OF VAPORIZERS FOR VOLATILE AGENTS
"Fluomatic" vaporizer. The gas volume of the
vaporizing chamber has been deliberately kept to
a minimum so that no serious volumes of halo-
thane vapour can b= discharged from the chamber
into the bypass during the deflationary phase.
The Fluomatic also operates with a significant
pressure drop of 8 cm H^O/l./min of gas flow
into it. This discourages any flow of vapour out
of the normal inlet to the vaporizing chamber
when the pressure in the chamber is released.
The Rowbotham and Goldman dental vapori-
zers (Goldman, 1962) have found favour for use
as halothane vaporizers inside a circle (Burton,
1958; Gusterson, 1959; Hall et al., 1966). The
Goldman vaporizer is so constructed that even at
high flow rates it cannot produce more than 3
per cent v/v of halothane. Bodman, Gerson and
Smith (1967) measured the inspired concentra-
tions in a circle system using a Goldman vapori-
zer and a halothane meter. With this simple type
of vaporizer, there is an appreciable surge of
vapour when it is first used, and the cooling
effect is not negligible. However, it works well
and was never designed as a precision vaporizer
(Goldman, 1966). It is usual to allow the patient
to breadie spontaneously with the vaporizer inside
the circle. Should he lighten, a compensatory
action occurs, his increased ventilation vaporizing
more anaesthetic. If IPPR is used, there is a risk
of vaporizing an excessive amount of anaesthetic
(Marret, 1959; Mushin and Galloon, 1960). This
risk can be minimized by using some form of
halothane analyzer in the circuit to measure the
inspired concentration.
VAPORIZERS UNDER HYPERBARIC AND HYPOBARIC
CONDITIONS
The saturated vapour pressure of a volatile anaes-
thetic agent is a function only of the ambient
temperature. For halothane it is 243 torr at 20" C,
giving a saturation concentration of 32 per cent
v/v. When the ambient pressure is increased by
1 atmosphere to 2 atmospheres absolute (2 a.t.a.)
the saturation concentration is halved to 16 per
cent. Although the anaesthetic concentration is
halved, the mass delivered per minute remains
sensibly constant, since the density of the vapour
mixture is now doubled at the higher pressure.
Thus we should expect little clinical difference
in the settings of anaesthetic vaporizers used in
657
hyperbaric operating rooms. This is borne out by
McDowall (1964) and Vermeulen-Cranch (1964).
There will be some slight differences, since the
flow-splitting ratios will be affected by the pres-
sure. Similar considerations apply under hypo-
baric conditions encountered at high altitudes
(Safar and Tenicella, 1964).
THE "PRESSURE POT" VAPORIZER
The idea of pressurizing an anaesthetic vaporizer
has been developed by Bracken, Brookes and Gold-
man (1968). They apply 4 atmospheres pressure,
i.e. 4.2 kg/sq.cm (60 Lb./sq.in. on the gauge) from
a pipeline containing oxygen, or premixed 50 per
cent oxygen and 50 per cent nitrous oxide (Ento-
nox) to a stout metal "pot" of 0.5 litre capacity
(fig. 15). Assuming that the saturation concentra-
tion of halothane contained in the pot is approxi-
mately 33 per cent, then by bringing die pot
FIG. 15
Cross-section of a pressurized vaporizer.
pressure up to 5 atmospheres absolute, Le. 4
atmospheres on the gauge, the halothane concen-
tration is reduced to 6.7 per cent Assume that
500 ml/min of gas at 4 atmospheres (gauge pres-
sure) is fed into the pot, on expanding to atmos-
pheric pressure this becomes 2.5 litres. If it is
required to produce a 2 per cent concentration,
the 6.7 per cent from the pot must be diluted by
adding a bypass gas flow of 5.9 L/min at atmos-
pheric pressure, so that a total volume of gas
plus vapour of 8.4 l./min is available.
658
THE CALIBRATION OF ANAESTHETIC VAPORIZERS
Nearly all manufacturers of calibrated vaporizers
use an optical method of calibration based upon
the measurement of the refractive index of the
emergent vapour mixture by means of a Rayldgh
refractometer (Edmondson, 1957; Luder, 1964),
air being used as the carrier gas. The method
has the advantage from the manufacturer's view-
point that the calibration of the refractometer,
once established, is very stable. The instrument
can be calibrated from known vapour mixtures
or from a knowledge of the refractive indices of
the vapours concerned. It is, however, only suit-
able for use with binary gas and vapour mixtures.
For accurate work, with other gases and water
vapour present, it is convenient to use a non-
dispersive infra-red gas analyzer (Hill, 1958). For
clinical use with circle systems, it is desirable to
have available a compact monitor, particularly
for halothane. Molyneux (1959) describes an
ultrasonic halothane monitor. Halothane readily
absorbs ultraviolet radiation, and by using a low-
pressure mercury lamp as a source of 2537 Ang-
strom unit radiation, a simple ultraviolet "halo-
thane meter" can be constructed (Robinson, Den-
son and Summers 1962; Wolfson, 1968). Although
giving a satisfactory performance, the ultraviolet
analyzer requires up to 1 hour to warm-up and
achieve its best stability. Halothane is also de-
composed by ultraviolet light, and care must be
taken to pass the effluent from the analyzer
through soda-lime if it is necessary to return it
to the circuit
Recently, the Drager company has introduced
the "Narkotest-M" non-electrical halothane analy-
zer. This works on the principle that halothane
vapour will diffuse through silicone rubber. A
small rise in pressure is then produced in a cap-
sule which is coupled to a pointer via a mechani-
cal linkage. The pointer moves over a scale cali-
brated 0-3 per cent halothane. The meter is
slightly affected by nitrous oxide, an anaesthetic
mixture of 70 per cent nitrous oxide, 30 per cent
oxygen being equivalent to 0.25 per cent halo-
thane. Thus the zero of the meter must first be
set on the gas mixture used before the halothane
is used. It must not be used in the presence of
ether or cyclopropane. Gas chromatography can
also be used for the measurement of halothane
and other volatile agents in anaesthetic circuits
BRITISH JOURNAL OF ANAESTHESIA
(Hill, I960), and is particularly useful for the
measurement of the concentrations of volatile
agents in blood (Butler and Hill, 1962).
For an absolute calibration of vaporizers, it is
best to use known vapour concentrations prepared
in alloy cylinders under pressure as described by
Hill (1961).
SERVICING OF VAPORIZERS
With any anaesthetic vaporizer, it is necessary to
carry out a regular routine servicing procedure.
The vaporizing chamber should be drained off
periodically; in the case of halothane vaporizers
this will avoid a build-up of thymol in the con-
tainer. The interior of the vaporizer should be in-
spected for any incipient corrosion, and the tap
checked for sticking. Grease should not be used,
as oxygen will be present when the vaporizer is
in use In the case of calibrated vaporizers, the
control knob should not bind, and the calibration
should be checked by the manufacturers at yearly
intervals. Adner and Hallen (1965) discuss relia-
bility aspects of anaesthetic vaporizers.
ACKNOWLEDGEMENTS
The author is indebted to the undermentioned manu-
facturers for permission to reproduce the various
illustrations: Dragerwerk (figs. 2, 14); Cyprane Ltd.
(figs. 3, 4, 13); Forreger Company (figs. 5, 6, 7, 8, 9,
10); British Oxygen Company Ltd. (figs. 11, 15);
Blease Medical Equipment Ltd. (fig. 12).
REFERENCES
Adner, M., and Hallen, B. (1965). Reliability of halo-
thane vaporisers. Acta anaesth. scand., 9, 233.
Bodman, R. I., Gerson, G., and Smith, K. (1967). A
simple closed circuit for halothane anaesthesia.
Anaesthesia, 22, 476.
Bracken, A. B., Brookes, R. C , and Goldman, V.
(1968). Pre-mixed gases—new equipment (To be
published.)
Brennan, H. J. (1957). A vaporizer for Fluothane. Brit.
J. Anaesth., 29, 332.
Burton, P. J. C (1958). Halothane concentrations from
a Rowbotham's bottle in a circle absorption sys-
tem. Brit. J. Anaesth., 30, 312.
Butler, R. A^ and Hill, D. W. (1962). Estimation of
volatile anaesthetics in tissues by gas chroma-
tography. Nature (Land.), 189, 488.
Coflis, J. M. (1966). Concentration graphs for the
Halox vaporiser. Anaesthesia, 21, 558.
Dobkin, A. B., Israel, J. S., Samonte, A. L., and Byles,
P. H. (1963). Universal anesthesia vaporizer useful
in disasters. N.Y. State J. Med., p. 1815.
Edmondson, W. (1957). Gas analysis by refractive
index measurement. Brit. J. Anaesth., 29, 570.
DESIGN AND CALIBRATION OF VAPORIZERS FOR VOLATILE AGENTS
Edmondson, W., and Hill, D. W. (1962). A pressuriz-
ing valve for the Fluotec vaporizer. Brit. J.
Anaesth,, 34, 741.
Epstein, H. G., and Macintosh, R_ (1956). An anaes-
thetic inhaler with automatic thermo-compensation.
Anaesthesia, 11, 83.
Feldman, S. A., and Morris, L. E. (1958). Vaporization
of ether and halothane in the Copper Kettle.
Anesthesiology, 19, 650.
Goldman, V. (1962). The Goldman halothane vaporiser
Mark 2. Anaesthesia, 17, 537.
(1966). Correspondence. Brit. J. Anaesth., 38,
980.
Gordh, T., Hallen, B., Okmian, L., WShlin, A., and
Stem, B. (1964). The concentration of halothane
by the combined use of Fluotec vaporizer and
Engstrom respirator. Ada anaesth. scand., 8, 97.
Gusterson, F. R. (1959). Halothane in the closed cir-
cuit, with special reference to prostatectomy.
Anaesthesia, 14, 35.
Hall, J. M , Hellewell, J., Fischer, E. L., Burns,
T. H. S., and Fuzzy, G. J. J. (1966). A test of two
types of halothane vaporizer. Brit. J. Anaesth.,
38, 484.
Hallen, B., and Norlander, O. P. (1966). Performance
of the Aga-Socsil vaporiser for volatile anaes-
thetics studied by gas chromatography. Acta
anaesth. scand., SuppL 26, 43.
Hedstrand, U. (1966). Aga anestor militar in clinical
use. Acta anaesth. scand., Suppl. 26, 53.
Hill, D. W. (1958). Halothane concentrations obtained
with a Fluotec vaporizer. Brit. J. Anaesth., 30,
563.
(1960). The application of gas chromatography
to anaesthetic research; in Gat Chromatography
(ed. R. P. W. Scott), p. 334. London: Butter-
worths.
(1961). Production of accurate gas and vapour
mixtures. Brit. J. appl. Physics, 12, 410.
(1963). Halothane concentrations obtained from a
DrSger Vapor vaporizer. Brit. J. Anaesth., 35, 285.
Lowe, H. J. (1962). Comparison of concentrations
of halothane in closed and semi-closed circuits
during controlled ventilation. Anesthesiology, 23,
291.
Jennings, A. M. C , and Hersant, M. E. (1965). In-
crease of halothane concentrations following refill-
ing of certain vaporizers. Brit. J. Anaesth., 37, 137.
Taylor, T. H., and Young, J. V. I. (1967). Nomo-
grams for the Halox vaporizer. Brit. J. Anaesth.,
39, 598.
Jensen, J. K. (1967). Halothankonzentrationen erreight
durch den "Oxford Miniature Inhaler". Anats-
thesist, 16, 54.
Kapfhammer, V., and Atabas, A. (1965). Der Fluotec
Mark 2 mit angebrauten Druckausgleich VentiL
Anaesthesist, 14, 18a.
Keenan, R. L. (1963). Prevention of increased pres-
sures in anesthetic vaporizers with a uni-
directional valve. Anesthesiology, 24, 732.
Keet, J. E., Valentine, G. W., and Riccio, J. S. (1963).
An arrangement to prevent pressure effect on the
Vernitrol vaporiser. Anesthesiology, 24, 734.
Leatherdale, R. A. L. (1966). The EMO ether inhaler
(clinical experience in a series of over 1000
anaesthetics). Anaesthesia, 21, 504.
Lowe, H. J., Beckham, L. M , Han, Y. H., and Evers,
J. L. (1962). Vaporizer performance: closed circuit
Fluothane anesthesia. Cwrr. Res. Anesth,, 41, 742.
659
Luder, M. (1964). Bestimmungen von Halothandamp-
Konzentrationen mit dem Laboratoriumsinter-
fcrometer. 1: Mitzeilung, Methodik. Anaesthesist,
13, 360.
McDowall, R. G. (1964). Anaesthesia in a pressure
chamber. Anaesthesia, 19, 331.
Macintosh, R., Mushin, W. W., and Epstein, H. G.
(1958). Physics for the Anaesthetist, 2nd ed.
Oxford: BlackweO.
Mackay, J. M (1957). Clinical evaluation of Fluothane
with special reference to a controlled percentage
vaporizer. Canad. Anaesth. Soc. J., 4, 235.
Mapkson, W. W. (1960). The concentration of anaes-
thetics in closed circuits with special reference to
halothane. 1: Theoretical study. Brit. J. Anaesth.,
32, 298.
Marrett, H. R. (1959). Halothane in use in the closed
circuit. Anaesthesia, 14, 28.
Martin, L. V. H. (1968). Observations on the Halox
vaporiser. Anaesthesia, 23, 119.
Martinez, L. R., Norlander, O. P., and Santos, A.
(1966). Laboratory evaluation of a Socsil vaporiser.
Acta anaesth. scand., SuppL 26, 75.
Massa, L. S., and Zander, H. L. (1964). Calibration
of a new vaporizer. Anesthesiology, 25, 708.
Merrifield, A. J., Hill, D. W., and Smith, K. (1967).
Performance of the Portoblease and the Fluoxair
portable anaesthetic equipment, with reference to
use under adverse conditions. Brit. J. Anaesth.,
39, 50.
Molyneux, L. (1959). Acoustic gas analyser. J. sci.
Instrum., 36, 118.
Morris, L. E. (1952). A new vaporizer for liquid
anesthetic agents. Anesthesiology, 13, 587.
Mushin, W. W., and Galloon, S. (1960). The concen-
tration of anaesthetics in closed circuits with
special reference to halothane. 3: Clinical aspects.
Brit. J. Anaesth., 32, 324.
Parbrook, G. D. (1966). A halothane vaporizer for
small animal anaesthesia. Anaesthesia, 21, 403.
Parkhouse, J. (1966). Clinical performance of the
O.MV. vaporiser. Anaesthesia, 21, 504.
Pearce, C. (1962). A versatile halothane vaporizer.
Anaesthesia, 17, 540.
Robinson, A., Denson, J. S., and Summers, F. W.
(1962). Halothane analyser. Anesthesiology, 23,
391.
Safar, P., and TeniceUa, R. (1964). High altitude
physiology in relation to anesthesia and inhala-
tional therapy. Anesthesiology, 25, 515.
Schreiber, P., and Weis, K. H. (1965). Konzentrations-
messungen mit dem Gardner-Universal-Verdamp-
fer. Anaesthesist, 14, 289.
Seed, R. F. (1967). Vaporization of halothane during
movement. Brit. J. Anaesth., U, 659.
Stephens, K. F. (1965). Transportable apparatus for
halothane anaesthesia. Brit. J. Anaesth., 37, 67.
Stetson, J. B. (1968). A simple improvement in the
EMO vaporizer. Brit. J. Anaesth., 40, 65.
Vermeulen-Cranch, D. M E. (1964). Anaesthesia in a
high pressure chamber; in Clinical Application of
Hyperbaric Oxygen (eds. I. Boerema, W. H.
Brummelkamp and N. J. Meijne), p. 206.
Amsterdam: Elsevier.
Wolfson, B. (1968). Appraisal of the Hook and Tucker
halothane meter. Anesthesiology, 29, 157.
Young, J. I. V. (1966). The practical use of the Halox
vaporiser. Anaesthesia, 21, 551.