Clinic of Anaesthesia and Intensive Care, St. Olav's University Hospital, Trondheim, Norway.
Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, NTNU, Trondheim, Norway.
Acta Anaesthesiol Scand. 2021 Aug;65(7):895-901. doi: 10.1111/aas.13825. Epub 2021 May 4.
In general anaesthesia practice a fresh gas flow (FGF) of ≥0.5 L/min is usually applied. Automated gas delivery devices are developed to reduce volatile anaesthetic consumption by limiting gas flow. This study aimed to compare desflurane consumption between automated gas control devices compared to conventional low flow anaesthesia in the Flow-I and Aisys anaesthesia machines, and to compare desflurane consumption between the two automated gas delivery devices. We hypothesised that desflurane consumption would be lower with automated gas delivery compared to conventional low flow anaesthesia, and that desflurane consumption could differ between the different gas delivery devices.
We allocated 160 patients undergoing robot-assisted laparoscopic surgery into four groups, Flow-I with automated gas control, Flow-i with conventional low-flow (1 L/min), Aisys with end tidal gas control and Aisys with conventional low flow. Patients were maintained at minimum alveolar concentration (MAC) 0.7-0.8. Desflurane consumption was recorded after 9, 30 and 60 minutes of anaesthesia.
After 60 minutes, compared to conventional low flow anaesthesia, automated gas delivery systems reduced desflurane consumption from 25.8 to 15.2 mL for the Aisys machine (P < .001) and from 22.1 to 16.8 mL for the Flow-I (P < .001). Time to MAC 0.7 and stable FGF was shorter with Aisys endtidal control compared to Flow-I automated gas control.
Under clinical conditions, we found a reduction in desflurane consumption when using automated gas delivery devices compared to conventional low flow anaesthesia. Both devices were reliable in use.
在全身麻醉中，通常应用新鲜气体流量（FGF）≥0.5 L/min。自动化气体输送设备旨在通过限制气流来减少挥发性麻醉剂的消耗。本研究旨在比较 Flow-I 和 Aisys 麻醉机中自动化气体控制装置与传统低流量麻醉相比，以及两种自动化气体输送装置之间的地氟醚消耗。我们假设与传统低流量麻醉相比，自动化气体输送的地氟醚消耗会更低，并且不同气体输送装置之间的地氟醚消耗可能会有所不同。
我们将 160 名接受机器人辅助腹腔镜手术的患者分为四组，Flow-I 与自动化气体控制、Flow-i 与传统低流量（1 L/min）、Aisys 与潮气末气体控制和 Aisys 与传统低流量。患者维持在最低肺泡浓度（MAC）0.7-0.8。记录麻醉后 9、30 和 60 分钟的地氟醚消耗。
与传统低流量麻醉相比，60 分钟后，自动化气体输送系统使 Aisys 麻醉机的地氟醚消耗从 25.8 降至 15.2 mL（P <.001），Flow-I 从 22.1 降至 16.8 mL（P <.001）。与 Flow-I 自动化气体控制相比，Aisys 潮气末控制达到 MAC 0.7 和稳定 FGF 的时间更短。
在临床条件下，与传统低流量麻醉相比，使用自动化气体输送装置可降低地氟醚消耗。两种装置均可靠。
