Inhalational anaesthesia with low fresh gas flow. 2013

Christian Hönemann, and Olaf Hagemann, and Dietrich Doll
Department of Anaesthesia and Operative Intensive Care Medicine, St. Marienhospital Vechta, Catholic Clinics Oldenburger Münsterland, Marienstraβe 6-8, 49377 Vechta, Germany.

During the inhalation of anaesthesia use of low fresh gas flow (0.35-1 L/min) has some important advantages. There are three areas of benefit: pulmonary - anaesthesia with low fresh gas flow improves the dynamics of inhaled anaesthesia gas, increases mucociliary clearance, maintains body temperature and reduces water loss. Economic - reduction of anaesthesia gas consumption resulting in significant savings of > 75% and Ecological - reduction in nitrous oxide consumption, which is an important ozone-depleting and heat-trapping greenhouse gas that is emitted. Nevertheless, anaesthesia with high fresh gas flows of 2-6 L/min is still performed, a technique in which rebreathing is practically negligible. This special article describes the clinical use of conventional plenum vaporizers, connected to the fresh gas supply to easily perform low (1 L/min), minimal (0.5 L/min) or metabolic flow anaesthesia (0.35 L/min) with conventional Primus Draeger(®) anaesthesia machines in routine clinical practice.

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