Anaes Cases · Vaporisers
Setting up low-flow closed-circuit anaesthesia with a vaporiser
The long case — the low-flow circle technique: the divergence of the vaporiser dial from the inspired concentration, the over-pressure, the inspired agent and oxygen monitoring, and the dry-absorbent carbon-monoxide risk.
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Prompt
A 58-year-old man for a three-hour abdominal surgery. The anaesthetist plans a low-flow (0.5 L/min) circle technique with sevoflurane. Discuss the vaporiser considerations, the monitoring requirements, and the risks.
Presentation
A 58-year-old, 80 kg man is scheduled for a three-hour open hemicolectomy. He is ASA 2 (well-controlled hypertension). The anaesthetist plans a low-flow circle technique — the fresh gas flow reduced to 0.5 L/min after induction, with sevoflurane titrated to a target end-tidal concentration of 1.7 to 2.0 per cent (age-adjusted MAC). Discuss the vaporiser and circuit considerations.
References2ShowHide
- [3]Parthasarathy S, Ravishankar M. The closed circuit and the low flow systems. Indian J Anaesth, 2013.PMID 24249885
- [24249886]Bersten AD, Soni N (eds) Oh's Intensive Care Manual. 8th edition, Elsevier, 2018.