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. 2019 Oct;63(10):814-819.
doi: 10.4103/ija.IJA_31_19. Epub 2019 Oct 10.

A randomised prospective comparison of equilibration point and changing gas composition during low-flow anaesthesia with sevoflurane vs desflurane

Pratibha Toal  1 , Sheetal Chiplonkar  1 , Pratik Panchal  2
Affiliations

A randomised prospective comparison of equilibration point and changing gas composition during low-flow anaesthesia with sevoflurane vs desflurane

Pratibha Toal et al. Indian J Anaesth. 2019 Oct.

Abstract

Background and aims: Safety and economy are the main concerns while using low- flow anaesthesia with newer inhalational agents. The main objective of this study was to use and compare 'equilibration time' of sevoflurane and desflurane after change-over from high-to-low flow anaesthesia.

Methods: This prospective study included consenting adult patients between 18-70 years undergoing elective surgery under general anaesthesia. Patients were randomised initially to receive high-flow anaesthesia with 1.3 MAC of either desflurane or sevoflurane with nitrous oxide. After equilibration point, low-flow anaesthesia was initiated. Heart rate, non-invasive blood pressure, pulse oximeter, 5 electrode ECG and gas monitoring was done. Statistical analysis was done with the help of Med CalC version 12.5.0.0 (student version) and IBM SPSS Version 20.0.

Results: Mean equilibration time in sevoflurane group was higher (4.59 ± 0.77 minutes) than desflurane group (3.78 ± 0.56 minutes, P < 0.001). Inspired concentrations of both inhalational agents varied from their vaporiser settings over 2 hours, more so with sevoflurane than desflurane. Inspired oxygen concentration (FiO2) remained above 30% during anaesthesia in both groups with stable haemodynamics.

Conclusion: Change-over from high-to-low flow anaesthesia is faster in desflurane. With fresh gas flow (FGF) of 1 L with 50% oxygen and dial concentration of 1-1.5% of sevoflurane and 3.8-4.4% of desflurane, the risk of hypoxia is minimal. The disparity between the set and delivered concentrations is more (20%) in sevoflurane than desflurane (12%).

Keywords: Desflurane; low-flow anaesthesia; sevoflurane.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Comparison of inspiratory O2 at various interval
Figure 2
Figure 2
Comparison of inspiratory N2O at various interval
See this image and copyright information in PMC

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