Background: Sevoflurane is suitable for low-flow anesthesia (LFA). LFA needs a wash-in phase. The reported sevoflurane wash-in schemes lack simplicity, target coverage, and applicability. We proposed a one-step 1-1-8 wash-in scheme for sevoflurane LFA to be used with both NO and Air. The objective of our study was to identify time for achieving each level of alveolar concentration of sevoflurane (FS) from 1 to 3.5% in both contexts.
Methods: We recruited 199 adults requiring general anesthesia with endotracheal intubation and controlled ventilation-102 in group NO and 97 in group Air. After induction and intubation, a wash-in was started using a fresh gas flow of O:NO or O:Air at 1:1 L·min plus sevoflurane 8%. The ventilation was controlled to maintain end-tidal CO of 30-35 mmHg.
Results: The rising patterns of FS and inspired concentration of sevoflurane (FS) are similar, running parallel between the groups. The FS/FS ratio increased from 0.46 to 0.72 within 260 s in group NO and from 0.42 to 0.69 within 286 s in group Air. The respective time to achieve an FS of 1, 1.5, 2, 2.5, 3, and 3.5% was 1, 1.5, 2, 3, 3.5, and 4.5 min in group NO and 1, 1.5, 2, 3, 4, and 5 min in group Air. The heart rate and blood pressure of both groups significantly increased initially then gradually decreased as FS increased.
Conclusions: The 1-1-8 wash-in scheme for sevoflurane LFA has many advantages, including simplicity, coverage, swiftness, safety, economy, and that it can be used with both NO and Air. A respective FS of 1, 1.5, 2, 2.5, 3, and 3.5% when used with NO and Air can be expected at 1, 1.5, 2, 3, 3.5, and 4.5 min and 1, 1.5, 2, 3, 4, and 5 min.
Trial Registration: This study was retrospectively registered with ClinicalTrials.gov (NCT03510013) on June 8, 2018.
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| http://dx.doi.org/10.1186/s12871-020-0940-2 | DOI Listing |
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