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The Safety and Quality of Low Flow Anaesthesia with Isoflurane, Sevoflurane and Desflurane

Year 2006, Volume: 11 Issue: 3, 170 - 174, 01.06.2006

Abstract

Objectives:Low flow anaesthesia is a method for reusing the expiration air. In this study we compare the anaesthesia quality and security at isoflurane, sevoflurane, desflurane in low flow anaesthesia. Materials and Methods: Ethical commity approval, ASA I-II group, 20-50 years old, 60 patients included into the study. The patients were randommily divided into 3 groups. 50 % O2 in 50 % air used for maintainance of anaesthesia, patients received 1,5 % isoflurane , 2 % sevoflurane, 5 % desflurane. Urea, creatinin, SGOT, SGPT, GGT, CK-MB, troponin blood samples obtained also both urine urea, creatinin measured. We examine the quality of awakening, recovery.Kruskal-Wallis, chi-square, ANOVA tests are used for the stastistical analysis. Results:The inspired O2 values decreased statistically significant at 7th period. The expired O2 values at sevoflurane group were statistically significant lower than control group at 8th,9th period.The inspired CO2 values at all three groups decreased statistically significant compared to control group.The expired CO2 values decreased CO2 values decreased statistically meaning fally at 6,8 and 9th periods at isoflurane group, when compared with 1th period, at 7,8 and 9 th periods at sevoflurane group , desflurane group.PaCO2 values at 1 th period were increased statistically significant at 6,8 and 9th periods in isoflurane and at 7,8 and 9th periods in both sevoflurane, desflurane groups. Conclusion: The low flow anaesthesia by all agents were secure. Three were no differences between the groups at lowering flows, however patients at desflurane group awaked , recovery earlier than other groups. ©2006, Fırat Üniversitesi, Tıp Fakültesi

References

  • Baum JA. Low-flow anaesthesia: The sensible and judicious use of inhalation anaesthetic M105. Acta Anaesthesiol Scand 1997;41: 264-267.
  • Coetzee JF, Stewart LJ. Fresh gas flow is not the only determinant of volatile agent consumption: a multi- centre study of low-flow anaesthesia. Br J Anaesth 2002; 88: 46-55
  • Baum JA. Low Flow Anaesthesia. The Theory and practice of low flow , minimal flow and closed system anaesthesia. 2nd English ed. London: Reed Educational and Professional Publishing Ltd, 2001.
  • Baum JA. Low-flow anaesthesia. Eur J Anaesthesiol 1996; 13:432-435.
  • Cotter SM, Petros AJ, Dore CJ, Barber ND, White DC. Low flow anaesthesia, practice cost implications and acceptability. Anaesthesia 1991; 46: 1009 – 1012
  • Baum J, Zuchner K, Holscher U, Sievert B, Stanke HG, Gruchmann T, Rathgeber J. Climatization of anesthetic gases using different breathing hose systems. Anaesthesist 2000; 49: 4 Wissing H, Kuhn I, Reitbrock S, Fuhr U. Pharmacokinetics of inhaled anaesthesics in a clinical setting: comparison of desflurane, isoflurane and sevoflurane. Br J Anaesth 2000; 84:443-449.
  • Brown B. Sevoflurane: Introduction and overview. Anesth Analg 1995; 81: 51-53.
  • Igarashi M, Watanabe H, Iwsaki H, Namiki A. Clinical evaluation of low-flow sevoflurane anaesthesia for paediatric patients. Acta Anaesthesiol Scand 1999; 43: 19-23.
  • Düşük Akımlı Anestezi Sempozyumu Konuşma Metinleri. Anestezi Dergisi 2002; 10: 119-156.
  • Pedersen FM, Nielsen J, Ibsen M, Guldager H. Low-flow isoflurane-nitrous oxide anaesthesia offers substantial economic advantages over high- and medium-flow isoflurane-nitrous oxide anaesthesia. Acta Anaesthesiol Scand 1993; 37: 509-512.
  • Baum J, Sievert B, Stanke HG, Brauer K, Sachs G. Nitrous oxide free low-flow anesthesia. Anaesthesiol Reanim 2000; 25: 60-67.
  • Bito H, Ikeda K. Long-duration, low-flow sevoflurane anesthesia using two carbon dioxide absorbents. Quantification of degradation products in the circuit. Anesthesiology 1994; 81:340-345
  • Bonome C, Belda J, Alvarez R, Soro M, Fernandez G, Cortes A. Low-flow anesthesia and reduced animal size increase carbowyhemoglobin levels in swine during desflurane and isoflurane breakdown in dried sodalaym. Anesth Analg 1999; 89:909-919.
  • Higuchi H, Hiroki W, Yumi U, Kohichiro G, Masuyuki K, Tetsuo S. Effects of probenecid on renal function in surgical patients anesthetized with low-flow sevoflurane. Anesthesiology 2001; 94: 21-31.
  • Ebert TJ, Frink EJ, Kharasch ED. Absence of biochemical evidence for renal and hepatic dysfunction after 8 hours of 1,25 minimum alveolar concentration sevoflurane anesthesia in volunteers. Anesthesiology 1998; 88: 601-610.
  • Lerman J, Davis PJ, Welborn LG, Orr RJ, Rabb M, Carpenter R, Motoyama E. Induction, recovery, and safety characteristics of sevoflurane in children undergoing ambulatory surgery. Anesthesiology 1996; 84: 1332-1340.
  • Naito Y, Tamai S, Shingu K, Fujimori R, Mori K. Comparison between sevoflurane and halothane for paediatric ambulatory anaesthesia. Br J Anaesth. 1991; 67: 387-389.
  • Piat V, Dubois MC, Johanet S, Murat I. Induction and recovery characteristics and hemodynamic responses to sevoflurane and halothane in children. Anesth Analg 1994 ; 79: 840-844.
  • Sarner JB, Levine M, Davis PJ, Lerman J, Cook DR, Motoyama EK. Clinical characteristics of sevoflurane in children. Anesthesiology 1995; 82: 38-46.
  • Hoffman WE, Charbel FT, Edelmen G, Ausman JI. Thiopental and desflurane for brain protection. Neurosurgery 1998; 43:1050-1053.

İzofluran, Desfluran ve Sevofluran ile Uygulanan Düşük Akımlı Anestezinin, Anestezi Kalitesi ve Güvenilirliğinin Karşılaştırılması

Year 2006, Volume: 11 Issue: 3, 170 - 174, 01.06.2006

Abstract

Amaç: Düşük akımlı anestezi ekspirasyon havasının yeniden kullanımını artırmayı amaçlayan bir yöntemdir. Bu çalışmada düşük akımlı anestezide, izofluran, sevofluran, desfluran güvenlik ve anestezi kalitesi açısından karşılaştırıldı. Gereç ve Yöntem: Etik kurul ve hasta onayıyla, 20-50 yaşlarında, ASA I-II, 60 hasta çalışmaya alındı. Hastalar randomize olarak 3 gruba (n=20) ayrıldılar. Anestezi idamesinde %50 O2, %50 hava içinde; izofluran grubuna (Grup İ) %1.5 izofluran, sevofluran grubuna (Grup S) %2 sevofluran, desfluran grubuna (Grup D) %5 desfluran, uygulandı. Anestezi süresince hemodinamik, solunumsal parametreler izlendi, kan gazı örnekleri alındı. Kanda üre, kreatinin, serum glutamik okzaloasetik transferaz, serum glutamik pürivik transferaz, laktat dehidrogenaz, gama glutamil transpeptitaz, kreatin kinaz myokard bandı, troponin, idrarda üre ve kreatinin ölçüldü. Uyanma, derlenme kalitesi değerlendirildi.Veriler, Kruskal- Wallis, chisquare ve ANOVA testleri ile değerlendirildi. p

References

  • Baum JA. Low-flow anaesthesia: The sensible and judicious use of inhalation anaesthetic M105. Acta Anaesthesiol Scand 1997;41: 264-267.
  • Coetzee JF, Stewart LJ. Fresh gas flow is not the only determinant of volatile agent consumption: a multi- centre study of low-flow anaesthesia. Br J Anaesth 2002; 88: 46-55
  • Baum JA. Low Flow Anaesthesia. The Theory and practice of low flow , minimal flow and closed system anaesthesia. 2nd English ed. London: Reed Educational and Professional Publishing Ltd, 2001.
  • Baum JA. Low-flow anaesthesia. Eur J Anaesthesiol 1996; 13:432-435.
  • Cotter SM, Petros AJ, Dore CJ, Barber ND, White DC. Low flow anaesthesia, practice cost implications and acceptability. Anaesthesia 1991; 46: 1009 – 1012
  • Baum J, Zuchner K, Holscher U, Sievert B, Stanke HG, Gruchmann T, Rathgeber J. Climatization of anesthetic gases using different breathing hose systems. Anaesthesist 2000; 49: 4 Wissing H, Kuhn I, Reitbrock S, Fuhr U. Pharmacokinetics of inhaled anaesthesics in a clinical setting: comparison of desflurane, isoflurane and sevoflurane. Br J Anaesth 2000; 84:443-449.
  • Brown B. Sevoflurane: Introduction and overview. Anesth Analg 1995; 81: 51-53.
  • Igarashi M, Watanabe H, Iwsaki H, Namiki A. Clinical evaluation of low-flow sevoflurane anaesthesia for paediatric patients. Acta Anaesthesiol Scand 1999; 43: 19-23.
  • Düşük Akımlı Anestezi Sempozyumu Konuşma Metinleri. Anestezi Dergisi 2002; 10: 119-156.
  • Pedersen FM, Nielsen J, Ibsen M, Guldager H. Low-flow isoflurane-nitrous oxide anaesthesia offers substantial economic advantages over high- and medium-flow isoflurane-nitrous oxide anaesthesia. Acta Anaesthesiol Scand 1993; 37: 509-512.
  • Baum J, Sievert B, Stanke HG, Brauer K, Sachs G. Nitrous oxide free low-flow anesthesia. Anaesthesiol Reanim 2000; 25: 60-67.
  • Bito H, Ikeda K. Long-duration, low-flow sevoflurane anesthesia using two carbon dioxide absorbents. Quantification of degradation products in the circuit. Anesthesiology 1994; 81:340-345
  • Bonome C, Belda J, Alvarez R, Soro M, Fernandez G, Cortes A. Low-flow anesthesia and reduced animal size increase carbowyhemoglobin levels in swine during desflurane and isoflurane breakdown in dried sodalaym. Anesth Analg 1999; 89:909-919.
  • Higuchi H, Hiroki W, Yumi U, Kohichiro G, Masuyuki K, Tetsuo S. Effects of probenecid on renal function in surgical patients anesthetized with low-flow sevoflurane. Anesthesiology 2001; 94: 21-31.
  • Ebert TJ, Frink EJ, Kharasch ED. Absence of biochemical evidence for renal and hepatic dysfunction after 8 hours of 1,25 minimum alveolar concentration sevoflurane anesthesia in volunteers. Anesthesiology 1998; 88: 601-610.
  • Lerman J, Davis PJ, Welborn LG, Orr RJ, Rabb M, Carpenter R, Motoyama E. Induction, recovery, and safety characteristics of sevoflurane in children undergoing ambulatory surgery. Anesthesiology 1996; 84: 1332-1340.
  • Naito Y, Tamai S, Shingu K, Fujimori R, Mori K. Comparison between sevoflurane and halothane for paediatric ambulatory anaesthesia. Br J Anaesth. 1991; 67: 387-389.
  • Piat V, Dubois MC, Johanet S, Murat I. Induction and recovery characteristics and hemodynamic responses to sevoflurane and halothane in children. Anesth Analg 1994 ; 79: 840-844.
  • Sarner JB, Levine M, Davis PJ, Lerman J, Cook DR, Motoyama EK. Clinical characteristics of sevoflurane in children. Anesthesiology 1995; 82: 38-46.
  • Hoffman WE, Charbel FT, Edelmen G, Ausman JI. Thiopental and desflurane for brain protection. Neurosurgery 1998; 43:1050-1053.
There are 20 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Aslı Yıldırım This is me

Hülya Göksu This is me

Gonca Çağlar Toprak This is me

Rıfat Kılıç This is me

Mehmet Akif Yaşar This is me

Publication Date June 1, 2006
Published in Issue Year 2006 Volume: 11 Issue: 3

Cite

APA Yıldırım, A., Göksu, H., Toprak, G. Ç., Kılıç, R., et al. (2006). İzofluran, Desfluran ve Sevofluran ile Uygulanan Düşük Akımlı Anestezinin, Anestezi Kalitesi ve Güvenilirliğinin Karşılaştırılması. Fırat Tıp Dergisi, 11(3), 170-174.
AMA Yıldırım A, Göksu H, Toprak GÇ, Kılıç R, Yaşar MA. İzofluran, Desfluran ve Sevofluran ile Uygulanan Düşük Akımlı Anestezinin, Anestezi Kalitesi ve Güvenilirliğinin Karşılaştırılması. Fırat Tıp Dergisi. June 2006;11(3):170-174.
Chicago Yıldırım, Aslı, Hülya Göksu, Gonca Çağlar Toprak, Rıfat Kılıç, and Mehmet Akif Yaşar. “İzofluran, Desfluran Ve Sevofluran Ile Uygulanan Düşük Akımlı Anestezinin, Anestezi Kalitesi Ve Güvenilirliğinin Karşılaştırılması”. Fırat Tıp Dergisi 11, no. 3 (June 2006): 170-74.
EndNote Yıldırım A, Göksu H, Toprak GÇ, Kılıç R, Yaşar MA (June 1, 2006) İzofluran, Desfluran ve Sevofluran ile Uygulanan Düşük Akımlı Anestezinin, Anestezi Kalitesi ve Güvenilirliğinin Karşılaştırılması. Fırat Tıp Dergisi 11 3 170–174.
IEEE A. Yıldırım, H. Göksu, G. Ç. Toprak, R. Kılıç, and M. A. Yaşar, “İzofluran, Desfluran ve Sevofluran ile Uygulanan Düşük Akımlı Anestezinin, Anestezi Kalitesi ve Güvenilirliğinin Karşılaştırılması”, Fırat Tıp Dergisi, vol. 11, no. 3, pp. 170–174, 2006.
ISNAD Yıldırım, Aslı et al. “İzofluran, Desfluran Ve Sevofluran Ile Uygulanan Düşük Akımlı Anestezinin, Anestezi Kalitesi Ve Güvenilirliğinin Karşılaştırılması”. Fırat Tıp Dergisi 11/3 (June 2006), 170-174.
JAMA Yıldırım A, Göksu H, Toprak GÇ, Kılıç R, Yaşar MA. İzofluran, Desfluran ve Sevofluran ile Uygulanan Düşük Akımlı Anestezinin, Anestezi Kalitesi ve Güvenilirliğinin Karşılaştırılması. Fırat Tıp Dergisi. 2006;11:170–174.
MLA Yıldırım, Aslı et al. “İzofluran, Desfluran Ve Sevofluran Ile Uygulanan Düşük Akımlı Anestezinin, Anestezi Kalitesi Ve Güvenilirliğinin Karşılaştırılması”. Fırat Tıp Dergisi, vol. 11, no. 3, 2006, pp. 170-4.
Vancouver Yıldırım A, Göksu H, Toprak GÇ, Kılıç R, Yaşar MA. İzofluran, Desfluran ve Sevofluran ile Uygulanan Düşük Akımlı Anestezinin, Anestezi Kalitesi ve Güvenilirliğinin Karşılaştırılması. Fırat Tıp Dergisi. 2006;11(3):170-4.