Evaluation of lung dynamics and respiratory functions in patients undergoing minimal flow anesthesia: a prospective, randomized controlled trial.

IF 2.9 Q2 MEDICINE, RESEARCH & EXPERIMENTAL
Medical Gas Research Pub Date : 2026-06-01 Epub Date: 2025-08-18 DOI:10.4103/mgr.MEDGASRES-D-25-00037
Erkan Cem Çelik, Ahmet Murat Yayik, Muhammed Enes Aydin, Ela Nur Medetoğlu Köksal, Esra Dişçi, Buğra Kerget, Omer Doymus, Elif Oral Ahiskalioğlu, Ali Ahiskalioğlu
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引用次数: 0

Abstract

JOURNAL/mgres/04.03/01612956-202606000-00005/figure1/v/2025-08-18T154854Z/r/image-tiff Low-flow anesthesia aims to minimize anesthetic gas consumption while maintaining adequate anesthesia. To examine the effects of minimal-flow anesthesia on perioperative lung dynamics and postoperative pulmonary function tests, a prospective, randomized controlled study was conducted between October 2023 and March 2024 at Atatürk University. A total of 66 patients (15 males, 45 females) with confirmed American Society of Anesthesiologists (ASA) grade I-II, aged 18-65 years, and scheduled for elective laparoscopic cholecystectomy were included in the study. Patients were randomized into two groups: MeFA (medium flow anesthesia, 2 L/min fresh gas flow) and MiFA (minimal flow anesthesia, 0.5 L/min fresh gas flow). In both groups, dynamic compliance values, peak inspiratory pressure (PIP) values, total inhalation anesthetic drug consumption, total remifentanil drug consumption, duration of anesthesia, duration of surgery, and spirometry test results were recorded. Respiratory measurements were recorded at the 5th minute after intubation (T1), 5th (T2), 10th (T3), 30th (T4), and 60th (T5) minutes after surgical incision and immediately after the surgical suturing (T6) pulse. There was no significant difference in compliance or PIP values between the groups from T1 to T5 (P > 0.05). However, at T6, the MeFA group exhibited a significant decrease in compliance and an increase in PIP compared with the MiFA group (P < 0.05). Additionally, significant differences in compliance and PIP values were found across all time intervals compared with those at T1, except for the T5-6 compliance values in the MiFA group (P < 0.001). No significant difference in respiratory function test values was noted between the groups (P > 0.05). The MiFA group exhibited a relatively milder reduction in compliance values and a lesser elevation in PIP values. Compared with medium-flow anesthesia, minimal-flow anesthesia may help mitigate perioperative lung function deterioration. These findings suggest potential benefits in preserving lung mechanics, warranting further research. This trial was registered at clinicaltrials.gov (identifier No. NCT06055335, registered March 25, 2023).

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微创麻醉患者肺动力学和呼吸功能的评估:一项前瞻性、随机对照试验。
低流量麻醉的目的是尽量减少麻醉气体的消耗,同时保持足够的麻醉。为了研究小流量麻醉对围手术期肺动力学和术后肺功能测试的影响,研究人员于2023年10月至2024年3月在atatrk大学进行了一项前瞻性随机对照研究。66例患者(男15例,女45例)经美国麻醉学会(ASA)分级为I-II级,年龄18-65岁,计划行择期腹腔镜胆囊切除术。患者随机分为两组:MeFA组(中流量麻醉,2 L/min新鲜气体流量)和MiFA组(最小流量麻醉,0.5 L/min新鲜气体流量)。记录两组患者的动态顺应性值、吸气峰压(PIP)值、吸入麻醉剂总用量、瑞芬太尼总用量、麻醉时间、手术时间、肺活量测定结果。分别于手术切口后第5分钟(T1)、第5分钟(T2)、第10分钟(T3)、第30分钟(T4)、第60分钟(T5)和手术缝合后第6分钟(T6)脉搏时记录呼吸测量。T1 ~ T5组间依从性及PIP值比较,差异无统计学意义(P < 0.05)。然而,在T6时,与MiFA组相比,MeFA组的依从性明显降低,PIP明显升高(P < 0.05)。此外,除MiFA组T5-6依从性值外,所有时间间隔的依从性和PIP值与T1相比均有显著差异(P < 0.001)。两组呼吸功能指标比较,差异无统计学意义(P < 0.05)。MiFA组依从性值下降相对较轻,PIP值升高较小。与中流量麻醉相比,小流量麻醉有助于减轻围手术期肺功能的恶化。这些发现表明保留肺力学的潜在益处,值得进一步研究。该试验已在clinicaltrials.gov注册(识别码:NCT06055335, 2023年3月25日注册)。
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来源期刊
Medical Gas Research
Medical Gas Research MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
5.10
自引率
13.80%
发文量
35
期刊介绍: Medical Gas Research is an open access journal which publishes basic, translational, and clinical research focusing on the neurobiology as well as multidisciplinary aspects of medical gas research and their applications to related disorders. The journal covers all areas of medical gas research, but also has several special sections. Authors can submit directly to these sections, whose peer-review process is overseen by our distinguished Section Editors: Inert gases - Edited by Xuejun Sun and Mark Coburn, Gasotransmitters - Edited by Atsunori Nakao and John Calvert, Oxygen and diving medicine - Edited by Daniel Rossignol and Ke Jian Liu, Anesthetic gases - Edited by Richard Applegate and Zhongcong Xie, Medical gas in other fields of biology - Edited by John Zhang. Medical gas is a large family including oxygen, hydrogen, carbon monoxide, carbon dioxide, nitrogen, xenon, hydrogen sulfide, nitrous oxide, carbon disulfide, argon, helium and other noble gases. These medical gases are used in multiple fields of clinical practice and basic science research including anesthesiology, hyperbaric oxygen medicine, diving medicine, internal medicine, emergency medicine, surgery, and many basic sciences disciplines such as physiology, pharmacology, biochemistry, microbiology and neurosciences. Due to the unique nature of medical gas practice, Medical Gas Research will serve as an information platform for educational and technological advances in the field of medical gas.
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