Low and minimal flow anesthesia: Angels dancing on the point of a needle

Mychaskiw, George

doi:10.4103/0970-9185.101883

Cited by 9 publications

(6 citation statements)

References 6 publications

(10 reference statements)

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“…Cost is certainly important in health care, particularly in this era of weak economies and limited resources. It is known that use of low and minimal fresh gas flow results in lower cost [21]. According to the studies of Odin, it was detected that 1% of all hospital expenditures come from anesthesia department, anesthetic drugs consist 5.7% of total consumption of drug storage of the hospital and volatile anesthetics consist 20% of this [22].…”

Section: Discussionmentioning

confidence: 99%

Influence of sevoflurane on hemodynamic parameters in low flow anesthesia applied without nitrous oxide

Debre

Sarıtaş²,

Şentürk³

2014

J Clin Exp Invest

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Bu çalışmada azotprotoksitsiz (N 2 O) düşük akımlı anestezide (DAA) sevofluranın hemodinamik açıdan etkilerini araştırılması amaçlandı. Yöntemler: Bu çalışmaya ASA I-II, 18-70 yaş arası 40 hasta dahil edildi. Hastalar rastgele iki gruba ayrıldı. Grup I'e (Azotprotoksitli DAA) 10 L/dk %100 O 2 ile 2 dk preoksijenizasyon uygulandı. Preoksijenizasyon sonrası, intravenöz yoldan sırası ile 4-7 mg/kg pentotal, 0,1 mg/ kg veküronyum ve 1 μg/kg fentanil uygulandı. 3 dk sonra endotrakeal entübasyon uygulandı. Entübasyonu takiben operasyonun ilk 10 dakikasında, 4 L/dk (%50 O 2 -%50 N 2 O) normal akım uygulandıktan sonra, 1 L/dk (%50 O 2 -%50 N 2 O) düşük akıma geçildi. Sevofluran konsantrasyonu, 0,8-1 MAK olarak preoperatif ortalama kan basıncı (OKB) ± %20 sınırlarında tutacak şekilde ayarlandı. Grup 2 (Azotprotoksitsiz DAA) ile Grup I arasında yapılan tüm işlemler, Grup 2'de N 2 O yerine hava kullanılması dışında aynı idi. Entübasyondan hemen sonra ve takip eden 15, 30, 45. ve 60. dakikalarda, hastaların kalp atım hızı (KAH), OKB, SpO 2 ve EtCO 2 değerleri kaydedilerek operasyonun bitimine 15 dakika kala tekrar 4 L/dk normal akıma geçildi. Bulgular: Sistolik kan basıncı (SKB) ve EtCO 2 değerleri bakımından; indüksiyon sonrası ölçümünden 60. dk. ölçüme kadar gruplar arasında anlamlı farklılık bulunamadı. Diyastolik kan basıncı (DKB), OKB ve KAH değerleri bakımından; 15. dk ölçümünde Grup 1'deki değerler Grup 2'ye göre daha yüksek bulundu (p<0,05). Hastalarda herhangi bir komplikasyona rastlanmadı. Sonuç: Uygun koşullar sağlanmak kaydıyla sevofluran ile uygulanan N 2 O'siz DAA tekniklerinin anestezi uygulamalarında tercih edilmesinin yararlı olduğu kanısına vardık.

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Section: Discussionmentioning

confidence: 99%

Influence of sevoflurane on hemodynamic parameters in low flow anesthesia applied without nitrous oxide

Debre

Sarıtaş²,

Şentürk³

2014

J Clin Exp Invest

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“…Інгаляційна анестезія в сучасній медицині зробила суттєвий крок вперед, що було пов'язане як з появою нових інгаляційних анестетиків (ізофлуран, севофлуран, ксенон), так і впровадженням нових анестезіологічних технологій: «Low fl ow anesthesia» та «Minimal fl ow anesthesia». Ці технології в інгаляційній анестезії виявились найбільш ефективними та максимально відповідають вимогам ERAS-протоколу [11][12]. Проте, ряд авторів вказує на відсутність клінічно значимих переваг використання внутрішньовенної чи інгаляційної анестезії при хірургічних втручаннях, про що дискусії ведуться до теперішнього часу [13].…”

Section: гастроезофагеальнаunclassified

Perioperative Metabolism of Patients With Esophageal Hernia of the Diaphragm

Denysenko¹,

DENISENKO²

2022

Pain Anaesth Int Care

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Summary: Premedication – medical and non-medical preparation of the patient for surgery or examination, which will take place with The study of perioperative changes in metabolism in patients undergoing laparoscopic surgical interventions for esophageal hiatal hernia (EHH) is relevant. The aim of the study. To study the perioperative metabolism in patients with EHH and evaluate the possibilities of its correction. Material and methods. The study was prospective, not randomized. 127 patients, aged 31-76 years, who underwent laparoscopic operations in connection with EHH, were studied (m-59, w-68). Preoperative risk ASA II-III. General anesthesia using the inhaled anesthetic sevoflurane and the narcotic analgesic fentanyl in conditions of low-flow artificial lung ventilation. Perioperative intensive care was carried out in accordance with the International Standards of Safe Anesthesiological Practice of the WFSA (World Federation of Societies of Anesthesiologists, 2010). In group I (n=61), a retrospective energy audit was carried out according to protocols for analgesia of medical charts and calculations of indirect calorimetry with determination of current metabolism (CM) and basal metabolism (BM). In group II (n=66), operational monitoring was supplemented with the use of indirect calorimetry with the determination of CM, BM, target metabolism (TM) and the degree of metabolic disturbance (DMD = 100×(TM-CM) / TM) %, and intensive therapy was supplemented additional infusion therapy and glucocorticoids, accordingly to the dynamics of metabolic changes. The results. The initial indicators of metabolism, in both groups, were without disturbance and significantly exceeded the basal level (in group I – by 30.5%, in group II – by 28.8%) and had the following values: in group I – 749±12 cal× min-1×m-2, in group II – 756±13 cal×min-1×m-2. In both groups, at the stage of reverse Trendelenburg position, imposition of pneumoperitoneum and the beginning of the operation, there were significant metabolic disturbances with a decrease to the basal level. In patients of group I, a slow recovery of PM was observed, the value of which at the moment of awakening remained 7.6% lower than the initial one (p<0.05). In patients of group II, against the background of increased infusion therapy and administration of glucocorticoids, PM recovery was more intense, and, at the moment of awakening, its value exceeded the corresponding value of group I by 10.4% (р<0.05). At the same time, CM and SPM were not high and did not differ from the initial values. Patients of group II, compared to group I, woke up faster and were transferred to the ward, and nausea and vomiting were 2.7 times less frequent: 7.35% in group II and 19.7% in group I (p<0, 05). After 6 and 12 hours after waking up, the feeling of pain on the VAS scale in group II was lower than in group I, respectively, by 24.3% and 34.4% (p < 0.05). Conclusions. Perioperative energy monitoring makes it safer to perform laparoscopic surgery in patients with EHH. Additional definition of the target metabolism and the degree of metabolic disturbance allows more effective construction of perioperative intensive therapy

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“…The absorption of CO2 was performed using a pure CO2 feed stream, to access the maximum absorption capacity of the [Cho + ][Lys -] solution (50 wt%). The CO2 flow rate was adjusted to 250 mL.min -1 , which is analogous to the minimal-flow anaesthesia mode [129]. The CO2 absorption by the ionic liquid occurs across the gas-liquid interface, due to the contact between the stabilised phases inside the pores of the PTFE capillaries of the membrane contactor.…”

Section: Co2 Capture Maximum Absorption Capacitymentioning

confidence: 99%