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low flow sevoflurane

Pranjali Kurhekar, Krishnagopal Vinod, J Shesha Dhiviya Krishna, M Sethuraman Raghuraman
Background: Ambulatory surgeries demand safe anesthesia with faster recovery which makes it expensive due to the cost of inhalational anesthetic agents such as sevoflurane and desflurane. Isoflurane is inexpensive agent but can cause delayed recovery. The aim of this study was to evaluate cost-benefit ratio of all three agent with respect to recovery and safety profile. Materials and Methods: Patients posted for elective ambulatory surgeries were divided into three groups...
October 2017: Anesthesia, Essays and Researches
Mauricio Loría Lépiz, Rebecca Sayre, Onkar Sawant, James Barr, Medora Pashmakova, Kevin Washburn, Shannon Washburn
OBJECTIVE To characterize the maternal and fetal cardiopulmonary effects of a low-dose infusion of dexmedetomidine without a loading dose in pregnant ewes anesthetized with sevoflurane. ANIMALS 11 pregnant ewes. PROCEDURES Anesthesia was induced with propofol and maintained with sevoflurane. Ewes and fetuses were instrumented with arterial and venous catheters, and thermodilution-pulmonary arterial catheters were placed in the ewes. Baseline measurements were obtained at an end-tidal sevoflurane concentration of 3...
November 2017: American Journal of Veterinary Research
A J Wetz, M M Mueller, K Walliser, C Foest, S Wand, I F Brandes, R M Waeschle, M Bauer
BACKGROUND: To ensure safe general anesthesia, manually controlled anesthesia requires constant monitoring and numerous manual adjustments of the gas dosage, especially for low- and minimal-flow anesthesia. Oxygen flow-rate and administration of volatile anesthetics can also be controlled automatically by anesthesia machines using the end-tidal control technique, which ensures constant end-tidal concentrations of oxygen and anesthetic gas via feedback and continuous adjustment mechanisms...
November 2017: Acta Anaesthesiologica Scandinavica
Petter Jakobsson, Madleine Lindgren, Jan G Jakobsson
Background: Modern anaesthesia workstations are reassuringly tight and are equipped with effective gas monitoring, thus providing good opportunities for low/minimal flow anaesthesia. A prerequisite for effective low flow anaesthesia is the possibility to rapidly increase and decrease gas concentrations in the circle system, thereby controlling the depth of anaesthesia.  Methods: We studied the wash-in and wash-out of sevoflurane in the circle system with fixed fresh gas flow and vaporizer setting. We compared two modern anaesthesia work stations, the Aisys (GE, Madison, WI, USA) and FLOW-i (Maquet, Solna, Sweden) in a test lung model...
2017: F1000Research
Lady Christine L Ong Sio, Richard Glenn C Dela Cruz, Alexander F Bautista
Sevoflurane and isoflurane are volatile halogenated ether widely used in anesthesia. Both have comparable potency and easy titratability but sevoflurane has lower pungency and results in faster patient recovery. Isoflurane, however, is more affordable. The nephrotoxicity of sevoflurane is undisputed but studies on isoflurane nephrotoxicity are lacking. The objective of this paper is to determine the overall nephrotoxicity profile of sevoflurane and isoflurane in donor nephrectomy patients using the renal function markers - nuclear glomerular filtration rate (GFR), serum creatinine, urine protein-to-creatinine ratio, proteinuria, and glucosuria...
January 2017: Medical Gas Research
Gökçen Duymaz, Seyhan Yağar, Ayşegül Özgök
OBJECTIVE: Numerous studies have indicated nephrotoxic effects of sevoflurane because of its two bioproducts compound A and fluoride. Cystatin C (CyC) is a more sensitive biomarker than creatinine to show early and mild changes in kidney function. We designed this prospective randomised study to compare the effects of low-flow sevoflurane anaesthesia and low-flow desflurane anaesthesia on renal functions based on CyC levels. No studies have evaluated the effects of low-flow sevoflurane anaesthesia on renal functions based on CyC levels to date...
April 2017: Turkish Journal of Anaesthesiology and Reanimation
Priyankar K Datta, Renu Sinha, Bikash Ranjan Ray, Venkateswaran Jambunathan, Riddhi Kundu
BACKGROUND: Sevoflurane is preferred for pediatric day care procedures. However, financial and environmental costs remain major limitations. Induction dose of sevoflurane could itself be sufficient for maintaining anesthesia with low fresh gas flow during short noninvasive procedures. METHODS: Fifty children, aged 1-5 years, scheduled for ophthalmic examination under anesthesia, were randomized into two groups. All children were induced with 8% sevoflurane in O2 : N2 O (40 : 60)...
February 2017: Paediatric Anaesthesia
Rajasree Omanakutty Amma, Subha Ravindran, Rachel Cherian Koshy, K M Jagathnath Krishna
BACKGROUND AND AIMS: With the availability of modern workstations and heightened awareness on the environmental effects of waste anaesthesia gases, anaesthesiologists worldwide are practicing low flow anaesthesia (LFA). Although LFA is being practiced in India, hard evidence on the current practice of the same from anaesthesiologists practicing in India is lacking and hence, we conducted this survey. METHODS: A questionnaire containing 16 questions was distributed among a subgroup of anaesthesiologists who attended the 2014 National Conference of Indian Society of Anaesthesiologists...
October 2016: Indian Journal of Anaesthesia
V I Gorban, A V Shchegolev, D A Kharitonov
OBJECTIVE: To compare anesthesia quality and sevoflurane consumption during standard and extended intraoperative monitoring. MATERIALS AND METHODS: 74 patients were included in prospective randomized study. Patients had spinal pathology of varying severity, extension and localization. A comparative evaluation of standard and extended (with entropy) monitoring was performed during low-flow inhalation anesthesia with the automated control of the anesthetic concentration and exhaled oxygen fraction (Et-control)...
March 2016: Anesteziologiia i Reanimatologiia
Marie Muyldermans, Serge Jennes, Stuart Morrison, Olivier Soete, Pierre-Michel François, Elkana Keersebilck, Thomas Rose, Olivier Pantet
OBJECTIVE: To describe a case of partial nephrogenic diabetes insipidus in a burned patient after prolonged delivery of low inspired concentrations of sevoflurane via an Anesthetic Conserving Device. DATA SOURCES: Clinical observation. STUDY SELECTION: Case report. DATA EXTRACTION: Relevant clinical information. DATA SYNTHESIS: A 34-year-old man was admitted with burns covering 52% of his total body surface area...
December 2016: Critical Care Medicine
Cihan Doger, Kadriye Kahveci, Dilsen Ornek, Abdulkadir But, Mustafa Aksoy, Derya Gokcinar, Didem Katar
Objective. The aim of this prospective, randomized study was to investigate the effects of low-flow sevoflurane anesthesia on the pulmonary functions in patients undergoing laparoscopic cholecystectomy. Methods. Sixty American Society of Anesthesiologists (ASA) physical status classes I and II patients scheduled for elective laparoscopic cholecystectomy were included in the study. Patients were randomly allocated to two study groups: high-flow sevoflurane anesthesia group (Group H, n = 30) and low-flow sevoflurane anesthesia group (Group L, n = 30)...
2016: BioMed Research International
Veena Chatrath, Ranjana Khetarpal, Divya Bansal, Harjinder Kaur
CONTEXT: While giving low-flow anesthesia, it is a routine practice to give fixed duration of initial high-flow. This study was conducted to show the use of equilibration point as changeover point from initial high-flow to low-flow. AIMS: It was to compare the use of equilibration point, hemodynamics, end-tidal agent concentration, recovery time, and recovery score between isoflurane and sevoflurane. SETTINGS AND DESIGN: It was a prospective randomized study conducted on 100 patients who were admitted for elective surgery expected to be < 2 h duration...
May 2016: Anesthesia, Essays and Researches
Alexander Dehouwer, Rik Carette, Simon De Ridder, Andre M De Wolf, Jan F A Hendrickx
Automated low flow anesthesia machines report how much inhaled anesthetic agent has been used for each anesthetic. We compared these reported values with the amount of agent that had disappeared by weighing the vaporizer/injectors before and after each anesthetic. The vaporizers/injectors of the Aisys, Zeus and FLOW-i were weighed with a high precision weighing scale before and after anesthesia with either desflurane in O2/air or sevoflurane in O2/N2O. These values were compared with the values reported by the cumulative agent use display tools of the respective anesthesia machines using a linear curve fit...
October 2016: Journal of Clinical Monitoring and Computing
Maria Horwitz, Jan G Jakobsson
BACKGROUND: The pharmacokinetics for sevoflurane and desflurane makes them suitable for low-flow anesthesia. The aim of the present study was to assess the use of desflurane and sevoflurane at constant vaporizer settings and fixed low fresh gas flows. METHODS: One hundred ASA 1-2 patients undergoing elective laparoscopic surgery were randomized into 4 groups (25 patients each): a fixed fresh gas flow 1.0 or 0.5 L/min with desflurane (D1.0 and D0.5) or sevoflurane (S1...
February 2016: Minerva Anestesiologica
Orhan Binici, Ismail Kati, Ugur Goktas, Lokman Soyaral, Osman Cagatay Aytekin
OBJECTIVES: In the current study, we compared the effects of low- and high-flow anesthesia techniques on hemorheology and coagulation parameters in patients who received sevofluran. METHODS: Forty patients classified as Risk Group I-II according to American Society of Anesthesiologists' (ASA) guidelines who were scheduled to undergo general anesthesia were randomly assigned to one of two groups. Low-flow anesthesia was administered to the first group, and high-flow anesthesia was used in the second group...
2015: Pakistan Journal of Medical Sciences Quarterly
Yunliang Yang, Tieying Song, Hong Wang, Kunfeng Gu, Pengyu Ma, Xiaojing Ma, Jianhui Zhao, Yuxia Li, JianHui Zhao, Guangyao Yang, Ruyu Yan
PURPOSE: To investigate the effects of two different inhalation anesthetic expelling methods on emergence agitation in infants following sevoflurane anesthesia. METHODS: 100 infants (1~3 years old) with cleft lip and palate and ASA classification I~II were randomized into two groups, a sevoflurane concentration decreasing expelling group (group n = 50 cases) and a low fresh gas flow expelling group (group D = 50 cases). The operation for cleft lip and palate repair was under general anesthesia, in which 30 minutes after initiation of narcosis ending extubation was indicated and after the tubes were removed the patients were sent to the post-anesthesia care unit (PACU) to record anesthesia times, emergence agitation scores, Ramsay scores and adverse reactions including drowsiness, respiratory depression, nausea and vomiting, chills, hiccough or laryngospasms...
2015: International Journal of Clinical and Experimental Medicine
Rik Carette, Andre M De Wolf, Jan F A Hendrickx
The FLOW-i anesthesia machine (Maquet, Solna, Sweden) can be equipped with automated gas control (AGC), an automated low flow tool with target control of the inspired oxygen concentration (FIO2) and end-expired concentration (FA) of a potent inhaled anesthetic. We examined the performance and quantitative aspects of the AGC. After IRB approval and individual informed consent, anesthesia in 24 ASA I-II patients undergoing abdominal or gynecological surgery was maintained with sevoflurane in O2/air with a target FIO2 of 40 % and a target sevoflurane FA (FAsevo) of 2...
June 2016: Journal of Clinical Monitoring and Computing
Na Xing, Xin Wei, Yanzi Chang, Yingying Du, Wei Zhang
BACKGROUND: Low-flow sevoflurane anesthesia has been shown to influence renal function in rats, but not in adult humans. Presently, no study has assessed the effects of sevoflurane on renal function in low birth weight infants. Our aim was to study the renal function in low birth weight infants undergoing surgery with low-flow sevoflurane anesthesia. METHODS: Forty infants graded as American Society of Anesthesiologists (ASA) grade I or II undergoing abdominal surgery were selected...
2015: BMC Anesthesiology
Kei Kondoh, Ayman Atiba, Kiyoshi Nagase, Shizuko Ogawa, Takashi Miwa, Teruya Katsumata, Hiroshi Ueno, Yuji Uzuka
In the present study, we compare a new carbon dioxide (CO2) absorbent, Yabashi lime(®) with a conventional CO2 absorbent, Sodasorb(®) as a control CO2 absorbent for Compound A (CA) and Carbon monoxide (CO) productions. Four dogs were anesthetized with sevoflurane. Each dog was anesthetized with four preparations, Yabashi lime(®) with high or low-flow rate of oxygen and control CO2 absorbent with high or low-flow rate. CA and CO concentrations in the anesthetic circuit, canister temperature and carbooxyhemoglobin (COHb) concentration in the blood were measured...
August 2015: Journal of Veterinary Medical Science
Idris E Ghijselings, Sofie De Cooman, Rik Carette, Philip J Peyton, Andre M De Wolf, Jan F A Hendrickx
Current hypoxic guards systems fail to maintain the inspired O2 concentration (FIO2) ≥ 21 % across the entire fresh gas flow (FGF) range when a second carrier gas is used (N2O or air). We examined the performance of the Maquet O2 Guard(®), a smart hypoxic guard that increases O2 delivery if an inspired hypoxic mixture is formed. After obtaining IRB approval and informed consent, 12 ASA I-II patients were enrolled. During anesthesia with sevoflurane in O2/air, the O2 Guard(®) was tested by administering O2/air at the following delivered hypoxic guard limits [expressed as (total FGF in L min(-1); FDO2 in %)] for 4 min each: [0...
February 2016: Journal of Clinical Monitoring and Computing
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