Low-flow anaesthesia (how to do it)

The practice of volatile anaesthetic agent delivery using afresh gas flow less than the minute volume has been with us since the early days of anaesthesia. Its popularity has closely paralleled the introduction of new volatile anaesthetic agents, where the cost saving of using low-flow is a prerequisite to affording a new, expensive agent.The introduction of Desflurane and Sevoflurane in the South African market over the past few years, along with the 0028 code for low-flow earlier this year has renewed interest in the technique. Some anaesthesia machines now come equipped with “econometers” designed to achieve the optimal fresh gas flow, while also reassuring one that an adequate fresh gas flow is being delivered. With the widespread availability of agent, CO2 and oxygen monitors the use of low-flow anaesthesia has become a predictable technique that can be titrated against measurable results.