Key result
Low flow anesthesia fails to reduce emergence agitation vs 2 L/min in gynecologic surgery.
Why the study?
The effect of low flow anesthesia on emergence agitation in women undergoing laparotomic gynecologic surgeries was unclear.
Does low flow anesthesia reduce emergence agitation in women undergoing laparotomic gynecologic surgeries?
RCT (n=64)
Double-blind
Computer-generated random number assignment
No
Does low flow anesthesia reduce emergence agitation in women undergoing laparotomic gynecologic surgeries?
Low flow anesthesia (0.5 L/min) results in a higher number of calm and cooperative patients during emergence compared to 2 L/min flow, without significantly changing overall emergence agitation rates.
Low-flow anesthesia does not reduce emergence agitation in gynecologic surgery; extends RCT evidence that flow rate has limited impact on agitation despite calmer emergence.
Objective: This prospective study aimed to determine whether low flow anesthesia (LFA) has an effect on emergence agitation in women who underwent laparotomic gynecologic surgeries. Method: Sixty four female patients were enrolled in this prospective randomized study. The patients were randomly allocated into two groups: Group 2 and Group 0.5. The fresh gas flow (FGF) rate was set at 4 L min-1 in both groups, initially. When all patients reached 1 minimum alveolar concentration of sevoflurane, the FGF rate was reduced to 2 L min-1 in Group 2 and 0.5 L min-1 in Group 0.5. For Group 0.5, vapor was closed 15 minutes before the end of surgery, while it was closed at the end of the operation for Group 2. At the end of the surgery, the FGF rate was increased to 4 L min-1. Emergence agitation was assessed using the Riker Sedation Agitation Scale (SAS) in the post-anesthesia care unit at 5, 10, 20 and 30th minutes. Results: Emergence agitation was observed in 5 patients, no significant difference was found between two groups. For all evaluation times, number of patients with SAS=4 was significantly higher in Group 0.5, while the number of patients with SAS<4 was significantly higher in Group 2 (p<0.05). Conclusion: The number of patients who are calm and cooperative was higher in LFA.
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Tuna et al. (2022) conducted an RCT in Emergence agitation (n=64). Low flow anesthesia vs. Fresh gas flow 2 L/min was evaluated on Incidence of emergence agitation (Riker Sedation-Agitation Scale score ≥5). Low flow anesthesia (0.5 L/min) did not significantly reduce the incidence of emergence agitation compared to 2 L/min in women undergoing gynecologic surgery, though it yielded more calm patients.
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