气候变化领域集成服务门户(CCPortal): Minimal flow anesthesia can be initiated early with the use of higher fresh gas flow to facilitate desflurane 'Wash-in'

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DOI	10.4103/joacp.JOACP_188_19
	Minimal flow anesthesia can be initiated early with the use of higher fresh gas flow to facilitate desflurane 'Wash-in'
	Kapoor M.; Sashank A.; Vats A.; Garg S.; Puri A.
发表日期	2019
ISSN	9709185
起始页码	487
结束页码	492
卷号	35 期号:4
英文摘要	More than 80 of delivered anesthetic gases get wasted at high fresh gas flows as they are vented out unused. Use of minimal flow anesthesia is associated with less waste anesthetic gas emission and environmental pollution. There is no approved or validated technique to initiate minimal flow anesthesia and simultaneously achieve denitrogenation of the breathing circuit. We studied the wash-in characteristics of desflurane, when delivered with 50 nitrous oxide, to reach a target end-tidal concentration at two different gas flow rates. Material and Methods: Patients were allocated randomly to two groups of 25 adults each. In Group A, with the vaporizer dial fixed at 4 vol , after an initial fresh gas flow of 4 L/min was administered to wash-in of desflurane using the closed-circuit, with 50 N2O in O2, and in group B, 6 L/min was used. Minimal flow anesthesia, with 0.5 L/min, was initiated in both groups on attaining a target end-tidal desflurane concentration of 3.5 vol . After initiation of desflurane delivery, the inspired/expired gas concentrations were noted every minute for 15 min. Results: In Group A, the target desflurane end-tidal concentration was reached in 499.2 ± 68.6 s±, and in the Group B (P < 0.001), it was reached significantly faster in 314.4 ± 69.89 s. Denitrogenation of the circuit was adequate in both groups. Conclusion: Minimal flow anesthesia can be initiated, without any gas-volume deficit, in about 5 min with an initial fresh gas flow rate of 6 L/min and the vaporizer set at 4 vol. Journal of Anaesthesiology Clinical Pharmacology \| Published by Wolters Kluwer - Medknow.
英文关键词	Desflurane wash-in; low flow anesthesia; minimal flow anesthesia; uptake of inhaled anesthetics
scopus关键词	atracurium besilate; desflurane; fentanyl; nitrous oxide; oxygen; propofol; adult; anesthesia induction; anesthesia level; Article; breathing rate; clinical article; closed circuit anesthesia; controlled study; end tidal carbon dioxide tension; expired air; female; gas flow; general anesthesia; human; low flow anesthesia; lung ventilation; male; neuromuscular blocking; nitrogen concentration; peak inspiratory flow; pilot study; randomized controlled trial; respiratory airflow; tidal volume; total lung capacity
来源期刊	Journal of Anaesthesiology Clinical Pharmacology
文献类型	期刊论文
条目标识符	http://gcip.llas.ac.cn/handle/2XKMVOVA/176341
作者单位	Department of Anaesthesia, Max Smart Super-Specialty Hospital, 6 DayanandVihar, Saket, Delhi, 110 092, India
推荐引用方式 GB/T 7714	Kapoor M.,Sashank A.,Vats A.,et al. Minimal flow anesthesia can be initiated early with the use of higher fresh gas flow to facilitate desflurane 'Wash-in'[J],2019,35(4).
APA	Kapoor M.,Sashank A.,Vats A.,Garg S.,&Puri A..(2019).Minimal flow anesthesia can be initiated early with the use of higher fresh gas flow to facilitate desflurane 'Wash-in'.Journal of Anaesthesiology Clinical Pharmacology,35(4).
MLA	Kapoor M.,et al."Minimal flow anesthesia can be initiated early with the use of higher fresh gas flow to facilitate desflurane 'Wash-in'".Journal of Anaesthesiology Clinical Pharmacology 35.4(2019).