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ORIGINAL ARTICLE
Year : 2019  |  Volume : 63  |  Issue : 10  |  Page : 814-819

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


1 Department of Anaesthesia, BARC Hospital, Anushakti Nagar, Mumbai, Maharashtra, India
2 Department of Anaesthesia, Spandan Multispeciality Hospital, Vadodara, Gujarat, India

Correspondence Address:
Dr. Sheetal Chiplonkar
Department of Anaesthesia, BARC Hospital, Anushakti Nagar, Mumbai - 400 094, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ija.IJA_31_19

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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%).


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