PubMed · 9138545
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M Georgieff. 1997. [Xenon].. https://doi.org/10.1055/s-2007-995006
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AIM: The large number of anaesthetics administered means that the total cost to a hospital of inhalational anaesthetic agent such as isoflurane or sevoflurane can be considerable. The total anaesthetic gas flow is a major determinant of the use of these agents. Modern anaesthetic machines and monitoring facilitate reduced gas flows, which can significantly reduce wastage of these anaesthetic agents. The purpose of this study was to audit gas flow rates and volatile anaesthetic use. METHODS: We audited gas flows and choice of anaesthetic agent over two one-month periods in one theatre at Christchurch Hospital. Data were collected directly from the anaesthetic machine using a computer. The second study period was clearly advised and followed widespread discussion of results from the first study period. RESULTS: Average fresh-gas flow was approximately 2 l/min (Month 1 = 2.0 l/min, Month 2 = 2.1 l/min). Use of the more expensive agent, sevoflurane, increased but gas flows with this agent decreased. CONCLUSIONS: Given the low flows used, the small difference between study periods was not surprising. The gas flows recorded represent responsible use of anaesthetic agents and are at least as good as flows achieved in previous studies that employed various methods to encourage their reduction.
Various mechanical problems with the delivery of anesthesia gases have been reported, and preoperative checks of the anesthesia delivery system are designed to prevent these. We report a case of a mechanical obstruction of the expiratory limb of the anesthesia circuit which went undetected before the induction of anesthesia. A check of the circuit was performed before the addition of circuit extensions, thus missing the obstruction. Systematic investigation of the anesthetic system after difficulty in ventilating the patient revealed the obstruction, without any harmful consequence to the patient. This case highlights the importance of a thorough check of the system before any anesthetic, particularly after any change in the circuit.
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