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LOW FLOW ANESTHESIA FOR AMBULATORY SURGERY

Hargasser, S. MD; Mielke, L. MD; Lanzinger, M. MD; Kling, M. MD; Entholzner, E. MD; Hipp, R. MD

doi: 10.1097/00000539-199802001-00010
Abstracts of Posters Presented at the International Anesthesia Research Society; 72nd Clinical and Scientific Congress; Orlando, FL; March 7-11, 1998: Ambulatory Anesthesia
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Institut fur Anaesthesologie, Klinikum rechts der Isar, Technische Universitat Munchen, 81675 Munich, Germany.

Abstract S10

For low flow anesthesia (LFA) techniques an initial high flow phase of 15-20 min is required, thus limiting the effectiveness in saving anesthetic vapors in short duration anesthesia. Anesthetic gas monitoring offers the opportunity to reduce the duration of the inital wash-in phase down to 1-2 min. This renders LFA practicable for brief surgical procedures. The aim of the study was to evaluate LFA for brief surgical procedures.

METHODS: After IRB approval and written informed consent the anesthetic procedure shown in Figure 1 was employed in an ambulatory surgery unit. After premedication with nordiazepam, anesthesia was induced with propofol (1-2mg/kg body weight) and alfentanil (1mg) and maintained with nitrous oxide in oxygen and isoflurane or enflurane. The patient's age, surgical procedure, duration of anesthesia and post-anesthetic care unit time spent were recorded. The consumption of anesthetic vapors per patient was calculated from the overall consumption.

Figure 1

Figure 1

RESULTS: 3185 consecutive patients were included in the study. The age of the patients ranged from 5 months to 94 years with a median of 31 years, duration of anesthesia from 15 min to 4 h with a median of 46 min. 29% of the patients were discharged from the post-anesthetic care unit within 2 h, 56% after 2-4 h and 15% after more than 4 h. On the average 24 l N2 O, 7.1 ml enflurane or 3.7 ml isoflurane (liquid) per patient were needed.

CONCLUSION: LFA proved to be a useful, practicable and cost-effective anesthetic technique for brief surgical procedures in ambulatory patients. The extremely short wash-in phase as compared to previously described LFA techniques can be achieved by using anesthetic gas monitoring.

© 1998 International Anesthesia Research Society