Key result
End-tidal controlled low-flow anesthesia significantly reduced total O2 consumption (61.01 L vs 66.86 L) and the number of vaporizer interventions compared to manual control.
Why the study?
The study aimed to compare the impact of manual and automated end-tidal control in low-flow anesthesia on anesthesia workload, inhalation agent consumption, and patient hemodynamic parameters.
Does automated end-tidal controlled low-flow anesthesia reduce inhalation agent consumption and anesthesia workload compared to manually controlled low-flow anesthesia in patients undergoing elective surgery?
RCT (n=96)
Single-blind
Sealed envelope randomization
No
Does automated end-tidal controlled low-flow anesthesia reduce inhalation agent consumption and anesthesia workload compared to manually controlled low-flow anesthesia in patients undergoing elective surgery?
Absolute Event Rate: 61.01% vs 66.86%
p-value: p=0.046
Automated end-tidal controlled low-flow anesthesia reduces anesthetist workload and oxygen consumption without increasing inhalation agent use compared to manual control.
End-tidal control may improve anesthesia efficiency; hypothesis-generating and should not change practice without larger trials.
Aim: In this study, it was aimed to compare the impact of manual and automated end-tidal control implementation in low-flow anesthesia on anesthesia workload, inhalation agent consumption, and hemodynamic parameters of patients. Material and Methods: In our study, 96 patients were divided into 2 groups as manual controlled low-flow anesthesia and end-tidal controlled low-flow anesthesia. Sevoflurane and O 2 consumption and efficiency in the groups, end-tidal O 2 , inspired and expired sevoflurane values, time to reach target end-tidal O 2 and sevoflurane values, time to deviation from target value, hemodynamic values, operation, anesthesia and awakening time, BIS, MAC and temperature values were followed and compared with the Aisys CS GE anesthesia device. Results: There was no statistically significant difference between the groups in terms of demographic data, operation, anesthesia, and recovery time and hemodynamic data. O 2 consumption was higher, time to reach target end-tidal oxygen and target EtO 2 deviation time was longer, O 2 efficiency was lower, and the number of interventions was higher in the manually controlled low-flow anesthesia group. There was no difference between the two groups in terms of total sevoflurane consumption and efficiency. Discussion: It has been concluded that the end-tidal controlled application of low-flow anesthesia does not increase the use of inhalation agents, the O 2 sensitivity is higher, it is hemodynamically safe, and the workload of the anesthetist is reduced due to the low number of interventions during the application.
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A 2022 study conducted an RCT in Elective surgery requiring orotracheal intubation (n=96). End-tidal controlled low-flow anesthesia vs. Manually controlled low-flow anesthesia was evaluated on Total O2 consumption (L) (p=0.046). End-tidal controlled low-flow anesthesia significantly reduced total O2 consumption (61.01 L vs 66.86 L) and the number of vaporizer interventions compared to manual control.
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