Department of Anaesthesiology, Critical Care and Pain Medicine, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India.
Med Gas Res. 2024 Sep 1;14(3):108-114. doi: 10.4103/2045-9912.385938. Epub 2023 Sep 17.
Although low-flow anesthesia is widely used due to its various advantages, there are concerns about potential and relative hypoxia. Furthermore, oxygen is also a drug with benefits and adverse effects. We aimed to evaluate and compare the effect of real-time oxygen consumption versus fixed flow-based low flow anesthesia on oxygenation and perfusion and to compare the economic benefits. With ethical approvals and informed consent, participants were randomly assigned to a dynamic group (13 males, and 27 females) receiving fresh gas flows depending on real-time oxygen consumption (dynamic O2: N2O), and a fixed group (20 males, and 13 females) receiving fixed fresh gas flows of 600 mL/min (with O2: N2O of 1:1). Oxygen partial pressure and serum lactate were comparable between groups. However, isoflurane consumed and costs incurred were significantly different. Total oxygen consumption per minute was also significantly lower in the dynamic group than the fixed group. No episodes of hypoxia were observed in either group. Real-time oxygen consumption-based low flow anesthesia is feasible and cost-effective without affecting the patient's global perfusion and outcome.
尽管由于其各种优点，低流量麻醉被广泛应用，但人们仍对潜在和相对缺氧存在担忧。此外，氧气也是一种具有益处和不良反应的药物。我们旨在评估和比较实时氧消耗与基于固定流量的低流量麻醉对氧合和灌注的影响，并比较其经济效益。在获得伦理批准和知情同意的情况下，参与者被随机分配到一个动态组（13 名男性和 27 名女性），根据实时氧消耗接受新鲜气体流量（动态 O2：N2O），和一个固定组（20 名男性和 13 名女性）接受固定新鲜气体流量 600 mL/min（O2：N2O 为 1:1）。两组之间的氧分压和血清乳酸水平相当。然而，异氟醚的消耗和成本存在显著差异。动态组每分钟的总氧气消耗也明显低于固定组。两组均未观察到缺氧发作。基于实时氧消耗的低流量麻醉是可行且具有成本效益的，不会影响患者的整体灌注和结果。
