Bandi Joshiraj, Harihar V Hegde, Sriramamoorthy R Marimuthu, Manisha Paul, Neethu George
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During the wash-in phase, FGF was set at 6 L/min with a sevoflurane vaporiser dial (FVS) of 3% in Group C and at 0.5 L/min with an FVS of 8% in Group OP. After achieving a FAS of 2%, FGF was reduced to 0.5 L/min in Group C, and FVS was adjusted to 4% in both groups, which were maintained for 15 min. The unpaired <i>t</i>-test was used to compare quantitative, normally distributed data, while the Mann-Whitney U test was used to compare quantitative, discrete data. A <i>P</i> value of less than 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Data from 45 patients (23 in Group C and 22 in Group OP) were analysed. The mean T<sub>target</sub> was significantly less in Group C than in Group OP [314 (SD: 145) vs 478 (SD: 100) s, <i>P</i> < 0.001]. The breathing system was 'stable' in a significantly higher number of patients (number, percentage) in Group OP compared to Group C (19, 86.4% vs 8, 34.8%) (<i>P</i> = 0.001). The number of vaporiser dial adjustments was significantly different (<i>P</i> = 0.005). The mean consumption of oxygen [50.7 (SD: 6.6) vs 36.4 (SD: 1.2) L, <i>P</i> < 0.001], air [19.2 (SD: 6.8) vs 4.0 (SD: 0.3) L, <i>P</i> < 0.001], and sevoflurane [6.7 (SD: 2) vs 3.3 (SD: 1) mL, <i>P</i> < 0.001] was significantly higher in Group C compared to Group OP.</p><p><strong>Conclusion: </strong>Our method of over-pressure wash-in during LFA initiation is simple, feasible, safe, efficient, economical, and environmentally friendly.</p>","PeriodicalId":13339,"journal":{"name":"Indian Journal of Anaesthesia","volume":"69 6","pages":"580-586"},"PeriodicalIF":2.9000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133035/pdf/","citationCount":"0","resultStr":"{\"title\":\"Feasibility, safety and efficiency of an over-pressure wash-in method using fresh gas flow 0.5 L and sevoflurane 8% during initiation of low-flow anaesthesia: A randomised, descriptional study.\",\"authors\":\"Bandi Joshiraj, Harihar V Hegde, Sriramamoorthy R Marimuthu, Manisha Paul, Neethu George\",\"doi\":\"10.4103/ija.ija_83_25\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and aims: </strong>Low-flow anaesthesia (LFA) typically involves a high fresh gas flow (FGF) of 4-6 L/min during the wash-in phase. 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引用次数: 0
摘要
背景和目的：低流量麻醉（LFA）通常涉及冲洗阶段4-6升/分钟的高新鲜气体流量（FGF）。我们的目的是评估LFA超压冲洗法（FGF = 0.5 L，七氟醚= 8%）的可行性、安全性和效率。主要目标是达到肺泡七氟烷（FAS）分数=2%（目标）所需的时间。次要目标包括呼吸系统稳定性、麻黄素使用和气体消耗。方法：48例18-65岁的患者在获得伦理许可和同意后，随机分为“常规”组（C组）和“超压”组（OP组）。在用阶段,FGF被设定为6 L / min七氟醚蒸发器拨号(艘)的3%在C组和0.5 L / min阵线8%组相机会实现2%的FAS之后,FGF减少到0.5升/分钟在C组,两组阵线是调整到4%,维持15分钟。用于比较定量未配对t检验,正态分布数据,而Mann-Whitney U测试是用来比较定量,离散数据。P值小于0.05认为有统计学意义。结果：对45例患者（C组23例，OP组22例）的资料进行分析。C组的平均target值明显低于OP组[314 (SD: 145) vs 478 (SD: 100) s, P < 0.001]。与C组相比，OP组呼吸系统“稳定”的患者人数（人数，百分比）显著增加（19.86.4% vs 8.34.8%） （P = 0.001）。蒸发器刻度盘调整次数差异有统计学意义（P = 0.005）。C组的平均耗氧量[50.7 (SD: 6.6) vs 36.4 (SD: 1.2) L, P < 0.001]、空气[19.2 (SD: 6.8) vs 4.0 (SD: 0.3) L, P < 0.001]、七氟醚[6.7 (SD: 2) vs 3.3 (SD: 1) mL, P < 0.001]均显著高于P组。结论：我们的LFA起始超压冲洗方法简单、可行、安全、高效、经济、环保。
Feasibility, safety and efficiency of an over-pressure wash-in method using fresh gas flow 0.5 L and sevoflurane 8% during initiation of low-flow anaesthesia: A randomised, descriptional study.
Background and aims: Low-flow anaesthesia (LFA) typically involves a high fresh gas flow (FGF) of 4-6 L/min during the wash-in phase. We aimed to assess the feasibility, safety, and efficiency of an over-pressure wash-in method (FGF = 0.5 L and sevoflurane = 8%) of LFA. The primary objective was the time required to achieve a fraction of alveolar sevoflurane (FAS) =2% (target). Secondary objectives included breathing system stability, ephedrine use, and gas consumption.
Methods: After obtaining ethical clearance and consent, 48 patients aged 18-65 years were randomised to two groups: 'conventional' (Group C) and 'over-pressure' (Group OP). During the wash-in phase, FGF was set at 6 L/min with a sevoflurane vaporiser dial (FVS) of 3% in Group C and at 0.5 L/min with an FVS of 8% in Group OP. After achieving a FAS of 2%, FGF was reduced to 0.5 L/min in Group C, and FVS was adjusted to 4% in both groups, which were maintained for 15 min. The unpaired t-test was used to compare quantitative, normally distributed data, while the Mann-Whitney U test was used to compare quantitative, discrete data. A P value of less than 0.05 was considered statistically significant.
Results: Data from 45 patients (23 in Group C and 22 in Group OP) were analysed. The mean Ttarget was significantly less in Group C than in Group OP [314 (SD: 145) vs 478 (SD: 100) s, P < 0.001]. The breathing system was 'stable' in a significantly higher number of patients (number, percentage) in Group OP compared to Group C (19, 86.4% vs 8, 34.8%) (P = 0.001). The number of vaporiser dial adjustments was significantly different (P = 0.005). The mean consumption of oxygen [50.7 (SD: 6.6) vs 36.4 (SD: 1.2) L, P < 0.001], air [19.2 (SD: 6.8) vs 4.0 (SD: 0.3) L, P < 0.001], and sevoflurane [6.7 (SD: 2) vs 3.3 (SD: 1) mL, P < 0.001] was significantly higher in Group C compared to Group OP.
Conclusion: Our method of over-pressure wash-in during LFA initiation is simple, feasible, safe, efficient, economical, and environmentally friendly.
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