Effect of Low‐flow Anesthesia Education on Knowledge, Attitude and Behavior of the Anesthesia Team

Abstract

The aim of this study was to evaluate the effect of education on the knowledge, attitude and behavior of anesthesiology staff and residents towards low-flow anesthesia. The staff and residents in the Department of Anesthesia and Reanimation, Zonguldak Karaelmas University were given theoretical and practical training in delivering low-flow anesthesia. To evaluate their attitudes and behaviors toward low-flow anesthesia, we collected data during the 6 months before training, during the first 3 months after training, and at 4-6 months after training. Anesthesia follow-up records, operation time, volatile anesthetic agent used, and the amount (in liters) of fresh gas low mid-anesthesia were recorded in all three stages. A total of 3,158 patients received general anesthesia and inhalation anesthesia was used in 3,115 of these patients. Our study group consisted of 2,752 patients who had no absolute or relative contraindications to low-flow anesthesia. While the mean fresh gas flow was 4.00 +/- 0.00 L/min before training, this level dropped to 2.98 L/min in the first 3 months after training, and to 3.26 L/min in the following 3 months. The mean fresh gas flow was significantly lower at the two post-training assessments than before training (p < 0.05). In conclusion, low-flow anesthesia may be used more frequently if educational seminars are provided to anesthetists. The use of low-flow anesthesia may increase further by allocating more time to this technique in anesthesia training programs provided at regular intervals.

Effect of low flow anesthesia educatıon on short term anesthetıc gas consumptıon

“…Çok uzun yıllardır etkileri bilinmesine rağmen, geliştirilen anestetiklerin CO 2 absorbanları veya vaporizatörlerin düşük akıma uygunsuzluğu, kazara hipoksi ve hiperkapni riski, anestetik gazın konsantrasyonunun aşırı veya yetersiz kalması riski gibi nedenlerle terk edilmiştir (1) . Fakat ileri monitörizasyon ve güvenlik özellik-lerine sahip modern anestezi çalışma istasyonlarının devreye girmesi bu kaygıları yersiz kılmıştır (1)(2)(3) . Uygun monitörizasyon ile kullanıldığında düşük taze gaz ile anestezi, anestetik gaz tüketiminin azalması, çevre kirliliğinde azalma, maliyetin azaltılması, anestetik gazların uygun şekilde nemlendirilmesi ve ısıtılması gibi önemli avantajlar sağlamaktadır (1,2,(4)(5)(6)(7)(8) .…”

“…Uygun monitörizasyon ile kullanıldığında düşük taze gaz ile anestezi, anestetik gaz tüketiminin azalması, çevre kirliliğinde azalma, maliyetin azaltılması, anestetik gazların uygun şekilde nemlendirilmesi ve ısıtılması gibi önemli avantajlar sağlamaktadır (1,2,(4)(5)(6)(7)(8) . Tüm bunlara rağmen, ülkemizde anestezi yönetimin-de düşük taze gaz akımı kullanımının sınırlı olduğu bilinmektedir (3) . Literatürde yaklaşık son 20 yıldır üzerine derinlemesine araştırmalar yapılmış, avantajları ve dezavantajları açıkça ortaya konmuş bir konu olmasına rağ-men, düşük taze gaz akımlı anestezi yönetimi ile ilgili çekinceler ve tartışmalar hâlâ devam etmektedir.…”

Limiting the accessibility of cost-prohibitive drugs reduces overall anesthetic drug costs: a retrospective before and after analysis

“…Though our department does not have a policy on limiting gas flows, several studies have shown significant annual savings using this technique. [4][5][6] A study at the University of Washington showed a significant reduction in fresh gas flows as well as a calculated annual savings of $104,916 by using a realtime decision support tool. 4 Implementation of a cost education program at the University of Michigan resulted in a decrease in cost per case of volatile anesthetics and neuromuscular blocking drugs after the intervention.…”

“…3 A major focus of research has been in the selection of appropriate anesthetic regimens and their cost-benefit comparisons. Some strategies for anesthetic cost containment have included systems to reduce fresh gas flow rates [4][5][6] and deliver provider-specific cost data. 4 Departments have also undertaken educational programs, implemented practice guidelines, and increased availability of anesthetic drug prices.…”

“…4 Departments have also undertaken educational programs, implemented practice guidelines, and increased availability of anesthetic drug prices. [6][7][8][9] These strategies have been associated with a reduction in drug costs, and utilization of less expensive anesthetic agents with appropriate substitutes has been shown to result in net cost reduction. 10 Nevertheless, some studies have shown conflict between anesthetic drug costs, recovery time, and patient outcomes.…”