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    Even lower is possible: Impact of flow rate on safety issues in low flow anaesthesia
    (Yerküre Tanıtım ve Yayıncılık A.Ş., 2019) Kepekçi, Ali Bestami; Omaygenç, Derya Özden; Karaca, İbrahim Oğuz; Telli, Serkan; Yücepur, Serkan; Özenç, Ecder
    Objective: Although various issues about low flow anaesthesia had been investigated previously, impact of different flow rates on perioperative follow-up and safety outcomes were not well-addressed. Here, we aimed to assess the influence of different flow rates of low flow fresh gas mixtures on hemodynamic state, gas exchange parameters and recovery time during general anaesthesia of urogenital system operations in a single tertiary centre. Materials and Methods: Sixty-two patients (American Society of Anaesthesiologists score I or II) to whom low flow anaesthesia with sevoflurane had been administered were subsequently gathered in three distinct -A, moderate flow (2 L/minimum), B, low flow (1 L/minimum), C, minimal flow (0.5 L/minimum) -groups. Hemodynamic data before and during anaesthesia, additionally, gas exchange and blood gas analysis parameters at 30th minute and before cessation of anaesthesia were recorded. Recovery period was observed by a second physician and times of interest were noted. Results: Demographic characteristics were similar among study groups. Most of the data regarding vital signs, gas exchange and blood gas analysis at the 30th minute and prior to cessation of anaesthesia were comparable. During operation, inspiratory sevoflurane levels were significantly higher in group A (1.7±0.6 vs 1.3±0.3 vs 1.3±0.3, p=0.043). There were no significant differences between the groups in terms of recovery data [time to spontaneous breathing (p=0.21), time to extubation (p=0.113), time to eye opening (p=0.5), time to verbal response (p=0.518) and time to reach a Modified Aldrete score of 9 or 10 (minimum, 13.7±6.8 vs 13.6±5.2 vs 14.8±4, p=0.717)]. Conclusion: Limiting the flow rate of gas mixture to 0.5 L/minutes in low flow anaesthesia maintenance may facilitate reduced utilization of volatile anaesthetics without a compromise in hemodynamic status and recovery process.

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