Low and minimal flow inhalational anaesthesia

Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie
A D Baxter

Abstract

To describe the pharmacokinetic behaviour and practical aspects of low (0.5-1 l.min-1) and minimal (0.25-0.5 l.min-1) flow anaesthesia. A Medline search located articles on low flow anaesthesia, and computer simulated anaesthetic uptake models are used. Most, 85-90%, of anaesthetists use high fresh gas flow rates during inhalational anaesthesia. Low/minimal flow anaesthesia with a circle circuit may avoid the need for in-circuit humidifiers, raise the temperature of inspired gases by up to 6 degrees C, reduce cost by about 25% by reduction of fresh gas flows to 1.5 l.min-1, and reduce environmental pollution with scavenged gas. Knowledge of volatile anaesthetic pharmacokinetic behaviour facilitates the use of minimal/low flow rates. Small amounts of nitrogen or minute amounts of methane, acetone, carbon monoxide, and inert gases in the circuit are of no concern, but the degradation of desflurane (to carbon monoxide by dry absorbent) and sevoflurane (to compound A by using a fresh gas flow of > 2 l.min-1) must be avoided. With modern gas monitoring technology, safety should be no more of a concern than with high flow techniques. The use of fresh gas flow rates of < 1 l.min-1 for maintenance of anaesthesia has many advantages, an...Continue Reading

References

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Citations

Jun 8, 2001·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·M YamakageA Namiki
Oct 12, 2013·Journal of Clinical Monitoring and Computing·Umberto LucangeloWalter A Zin
Jun 2, 2012·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Metha BrattwallJan Jakobsson
Apr 23, 2013·Revista brasileira de anestesiologia·Semiha BarçınBayazit Dikmen
Aug 6, 2000·European Journal of Anaesthesiology·A SuzukiS Sato
Mar 15, 2012·Anesthesia and Analgesia·Jeffrey M Feldman
Nov 8, 2008·Annales Françaises D'anesthèsie Et De Rèanimation·E QuénetV Billard
Jul 4, 2009·Acta Anaesthesiologica Scandinavica·A Cherian, A Badhe
May 18, 2004·Anaesthesia·S RassamM Stacey
Mar 11, 2011·Korean journal of anesthesiology·Ho-Geol RyuSeong-Won Min
Jan 2, 2013·Korean journal of anesthesiology·Sang Yoong ParkSo Ron Choi
Aug 24, 2017·Acta Anaesthesiologica Scandinavica·A J WetzM Bauer

Nov 27, 2020·Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS·Benedict WeberSelena Knoth
Feb 4, 2021·Anesthesia and Pain Medicine·Hong Seuk YangChang Young Jeong

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