Low-flow anaesthesia with a fixed fresh gas flow rate. 2019

Seyma Bahar, and Mahmut Arslan, and Aykut Urfalioglu, and Gokce Gisi, and Gozen Oksuz, and Bora Bilal, and Hafize Oksuz, and Adem Doganer
Department of Anesthesiology and Reanimation, School of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey.

During the wash-in period in low flow anaesthesia (LFA), high fresh gas flow is used to achieve the desired agent concentration. In this study, we aimed to evaluate the safety of fixed 1 L/min fresh gas flow desflurane anaesthesia in both the wash-in and maintenance periods in patients including the obese ones. 104 patients undergoing surgery under general anaesthesia were included. After endotracheal intubation, fresh gas flow was reduced to 1 L/min and the desflurane vaporizer was set at 18%. The time from opening the vaporizer to end-tidal desflurane concentration reaching 0.7 MAC was recorded (MAC 0.7 time). Throughout the surgery, hemodynamic variables, FIO2, MAC and BIS values were observed. MAC 0.7 time, BIS and MAC values at the start of surgery, number of adjustments in vaporizer settings, desflurane consumption were recorded. The average MAC 0.7 time was 2.9 ± 0.5 min. MAC and BIS values at the start of the surgery were 0.7 (0.6-0.8) and 39 ± 8.5 respectively. No individual patient had a BIS value above 60 throughout the surgery. Hemodynamic variables were stable and FIO2 did not fall below 30% in any patient. The number of adjustments in vaporizer settings was 56. Average desflurane consumption was 0.33 ± 0.05 mL/min. We demonstrated that LFA without use of initial high fresh gas flow during the wash-in period is an effective, safe and economic method which is easy to perform.

UI MeSH Term Description Entries
D007530 Isoflurane A stable, non-explosive inhalation anesthetic, relatively free from significant side effects.
D008297 Male Males
D008738 Methyl Ethers A group of compounds that contain the general formula R-OCH3. Ethers, Methyl
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009330 Nebulizers and Vaporizers Devices that cause a liquid or solid to be converted into an aerosol (spray) or a vapor. It is used in drug administration by inhalation, humidification of ambient air, and in certain analytical instruments. Atomizers,Inhalation Devices,Inhalators,Inhalers,Vaporizers,Nebulizers,Vaporizers and Nebulizers,Atomizer,Device, Inhalation,Devices, Inhalation,Inhalation Device,Inhalator,Inhaler,Nebulizer,Vaporizer
D005260 Female Females
D006439 Hemodynamics The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM. Hemodynamic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000077149 Sevoflurane A non-explosive inhalation anesthetic used in the induction and maintenance of general anesthesia. It does not cause respiratory irritation and may also prevent PLATELET AGGREGATION. BAX 3084,Fluoromethyl Hexafluoroisopropyl Ether,Fluoromethyl-2,2,2-trifluoro-1-(trifluoromethyl)ethyl Ether,Sevorane,Ultane
D000077335 Desflurane A fluorinated ether that is used as a volatile anesthetic for maintenance of general anesthesia. 1,2,2,2-Tetrafluoroethyl difluoromethyl ether,I 653,I-653,I653,Suprane

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