Low-flow Sevoflurane Anesthesia Research Articles

Evaluation of the Effect and Value of Low-flow Sevoflurane Anesthesia in Laparoscopic Surgery

Evaluation of the Effect and Value of Low-flow Sevoflurane Anesthesia in Laparoscopic Surgery

Incidence of Postoperative Renal Injury after Receiving Different Exposure of Low-Flow Sevoflurane in General Anesthesia

Objective: To compare postoperative renal injury in low-flow sevoflurane anesthesia between more and less than two MAC-hours, and to determine the potential predisposing factors of postoperative renal injury. Materials and Methods: The present study was a retrospective cohort study that included 400 patients who underwent low-flow general anesthesia with sevoflurane, determining maintenance of fresh gas flow not exceeding one liter per minute. All subjects were classified into two groups, those exceeding two MAC-hours and those receiving less than two MAC-hours. The diagnosis of postoperative renal injury followed the Kidney Disease Improving Global Outcomes criteria. The multivariable logistic regression analysis was performed to identify independent risk factors for postoperative acute kidney injury. Results: The incidences of postoperative acute kidney injury among the patients received more and less than two MAC-hours groups were 20.1% and 21.5%, respectively (p=0.876). Factors found to be associated with postoperative acute kidney injury were ASA classification 2 (adjusted OR 7.82, 95% CI 1.0 to 59.2), ASA physical status 3 or higher (adjusted OR 9.85 95% CI 1.3 to 76.4), and obesity (adjusted OR 5.74, 95% CI 2.0 to 16.4). Exposure to low-flow sevoflurane for more than two MAC-hours was not associated with postoperative renal injury (adjusted odds ratio 0.89, 95% CI 0.5 to 1.5, p=0.666). Conclusion: Exposure to low-flow sevoflurane exceeding two MAC-hours did not increase the risk of postoperative acute kidney injury. Keywords: Acute kidney injury; Low flow general anesthesia; Sevoflurane

Оптимізація анестезіологічного забезпечення пері- та післяопераційного періоду при хірургічному лікуванні колоректального раку

Мета дослідження — вибір оптимального методу анестезіологічного захисту хворих від операційної агресії при хірургічному лікуванні колоректального раку. Проведено порівняльний аналіз клінічних показників і результатів лікування при використанні атаралгезії з подальшою аналгезією наркотичними анальгетиками та комбінованої методики з використанням низькопотокової анестезії севофлураном та епідуральної аналгезії з подальшим подовженим епідуральним знеболюванням. Показано вірогідну перевагу комбінованої методики перед тотальною внутрішньовенною анестезією за рахунок нормодинамічного типу гемодинаміки упродовж всієї операції, ранньої регресії постнаркозної депресії і можливості екстубації пацієнта в операційній, ефективної аналгезії в ранньому післяопераційному періоді. Методика подовженої епідуральної аналгезії порівняно з опіатною аналгезією забезпечила значне зниження потреби в опіоїдних анальгетиках, ефективну і якісну аналгезію в післяопераційному періоді, нівелювала побічні ефекти опіатних препаратів, знизила тривалість перебування пацієнта у відділенні інтенсивної терапії. Впроваджена методика дозволила знизити частоту післяопераційної летальності, кількість ускладнень, середню тривалість ліжко-дня і частоту повернень пацієнтів у відділення інтенсивної терапії.

Sevoflurane sedation and nephrogenic diabetes insipidus in patients affected with severe acute respiratory syndrome coronavirus 2.

Sevoflurane sedation and nephrogenic diabetes insipidus in patients affected with severe acute respiratory syndrome coronavirus 2.

1-1-8 one-step sevoflurane wash-in scheme for low-flow anesthesia: simple, rapid, and predictable induction

BackgroundSevoflurane is suitable for low-flow anesthesia (LFA). LFA needs a wash-in phase. The reported sevoflurane wash-in schemes lack simplicity, target coverage, and applicability. We proposed a one-step 1-1-8 wash-in scheme for sevoflurane LFA to be used with both N2O and Air. The objective of our study was to identify time for achieving each level of alveolar concentration of sevoflurane (FAS) from 1 to 3.5% in both contexts.MethodsWe recruited 199 adults requiring general anesthesia with endotracheal intubation and controlled ventilation—102 in group N2O and 97 in group Air. After induction and intubation, a wash-in was started using a fresh gas flow of O2:N2O or O2:Air at 1:1 L·min− 1 plus sevoflurane 8%. The ventilation was controlled to maintain end-tidal CO2 of 30–35 mmHg.ResultsThe rising patterns of FAS and inspired concentration of sevoflurane (FIS) are similar, running parallel between the groups. The FAS/FIS ratio increased from 0.46 to 0.72 within 260 s in group N2O and from 0.42 to 0.69 within 286 s in group Air. The respective time to achieve an FAS of 1, 1.5, 2, 2.5, 3, and 3.5% was 1, 1.5, 2, 3, 3.5, and 4.5 min in group N2O and 1, 1.5, 2, 3, 4, and 5 min in group Air. The heart rate and blood pressure of both groups significantly increased initially then gradually decreased as FAS increased.ConclusionsThe 1-1-8 wash-in scheme for sevoflurane LFA has many advantages, including simplicity, coverage, swiftness, safety, economy, and that it can be used with both N2O and Air. A respective FAS of 1, 1.5, 2, 2.5, 3, and 3.5% when used with N2O and Air can be expected at 1, 1.5, 2, 3, 3.5, and 4.5 min and 1, 1.5, 2, 3, 4, and 5 min.Trial registrationThis study was retrospectively registered with ClinicalTrials.gov (NCT03510013) on June 8, 2018.

Effect of low-flow sevoflurane anesthesia on early postoperative renal function

Objective To evaluate the effect of low-flow sevoflurane anesthesia on the early postoperative renal function in patients. Methods Sixty patients of both sexes, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, aged 18-64 yr, scheduled for elective non-urological surgery with general anesthesia, with an expected surgical duration>4 h, were divided into 2 groups (n=30 each) using a random number table method: middle-flow anesthesia group (groupⅠ) and low-flow anesthesia group (group Ⅱ). Anesthesia was induced with IV midazolam, sufentanil, propofol and cisatracurium besylate.Mechanical ventilation was performed after tracheal intubation.Pure oxygen served as carrier, the fresh gas flow of oxygen was set at 4-5 L/min, sevoflurane was inhaled for 10-15 min, and then fresh gas flow was decreased to 2 L/min(groupⅠ) and 0.5 L/min (group Ⅱ). End-tidal pressure of carbon dioxide was maintained at 35-45 mmHg.The end-tidal concentration of sevoflurane was set at 2.0%-2.4%, remifentanil and cisatracurium besylate were infused intravenously, and sufentanill or propofol was injected intermittently to maintain anesthesia.Bispectral index value was maintained at 40-60 during operation.Before anesthesia induction (T0), at 1, 2, 3 and 4 h after anesthesia induction (T1-4), immediately after operation (T5) and at 24 h after operation (T6), peripheral venous blood samples were collected for determination of serum fluoride ion concentrations.Peripheral venous blood samples and urine specimens were collected at T0, T5, T6, 48 h after operation (T7) and 72 h after operation (T8) for determination of creatinine (Cr), blood urea nitrogen (BUN) and cystatin C (Cys C) and serum and urine β2-microglobulin (β2-MG) concentrations. Results Compared with the baseline at T0, serum fluoride ion concentrations were significantly increased at T1-6 in two groups, the serum Cys C concentration was increased at T5, and serum and urine β2-MG concentrations were increased at T5 and T6 in groupⅠ, serum Cr and BUN concentrations and serum and urine β2-MG concentrations were increased at T5 and T6, and the serum Cys C concentration was increased at T5-T7 in groupⅡ (P<0.05). Compared with groupⅠ, serum fluoride concentrations were significantly increased at T1-6, serum Cr and BUN concentrations and serum and urine β2-MG concentrations were increased at T5, and serum Cys C concentrations at T5-T7 and urine β2-MG concentrations at T5 and T6 were increased in groupⅡ (P<0.05). Conclusion Low-flow sevoflurane anesthesia produces no marked effect on early postoperative renal function in patients. Key words: Anesthetics, inhalation; Kidney function tests; Fresh gas flow

Effect of Low-flow Sevoflurane Anaesthesia on Renal Functions in Patients Undergoing Surgery: A Retrospective Study

Effect of Low-flow Sevoflurane Anaesthesia on Renal Functions in Patients Undergoing Surgery: A Retrospective Study

Comparison of Effects of Low-Flow Sevoflurane and Low-Flow Desflurane Anaesthesia on Renal Functions Using Cystatin C.

Numerous studies have indicated nephrotoxic effects of sevoflurane because of its two bioproducts compound A and fluoride. Cystatin C (CyC) is a more sensitive biomarker than creatinine to show early and mild changes in kidney function. We designed this prospective randomised study to compare the effects of low-flow sevoflurane anaesthesia and low-flow desflurane anaesthesia on renal functions based on CyC levels. No studies have evaluated the effects of low-flow sevoflurane anaesthesia on renal functions based on CyC levels to date. Thirty American Society of Anesthesiologists (ASA) physical status I-II patients who were scheduled for urological procedures were enrolled in this study. The patients were randomly assigned to 2 groups: low-flow sevoflurane anaesthesia or low-flow desflurane anaesthesia. Serum urea, creatinine and CyC levels were measured before the operation, just before extubation and 24 h after the operation. Creatinine clearance was calculated in the first 24-h urine sample. There were no significant differences in serum urea, creatinine and CyC levels or 24 h creatinine clearance between the groups. Our study demonstrates with a more sensitive biomarker, CyC, that low-flow sevoflurane anaesthesia is safe in terms of the effects on renal function.

Optimization of anesthetic management of surgical treatment of colorectal cancer: сlinical and morphological parallels.

Background. Interest in the study of the properties of sevoflurane, increased in recent years due to its influence on hemodynamics and morphological condition of the respiratory department of lungs, causes advisability of analyzing the structure of organs directly involved in the reactions of radical surgery for colorectal cancer. Objective. The purpose of the study is to select the optimal method of anesthesia protection of patients from operating aggression during surgical treatment of colorectal cancer and comparative analysis of tissue and cell ultrastructure in intraoperative biopsies of the colon in the conditions of application of the standard ataralgesia and combined anesthesia with epidural analgesia. Methods. It was performed a comparative analysis of clinical and morphological data and results of treatment of the colon using total intravenous anesthesia followed analgesia with opiates analgesics, and combined techniques using low-flow sevoflurane anesthesia and epidural analgesia, followed by prolonged epidural anesthesia. Results. It was shown a significant advantage of combined techniques in comparison with total intravenous anesthesia due to: normodynamic type of hemodynamics during operation, possibility to extubate patient in operating room, effective analgesia in early postoperative period. Implemented methodology reduced the frequency of postoperative mortality, complications, average length of hospital stay and frequency of patient returns to intensive care unit. The central link in the development of pathological changes in the colon wall at anesthesiology maintenance of surgical interventions in the treatment of colorectal cancer is the system of microcirculation. Combined low-flow sevoflurane inhalation anesthesia and epidural analgesia with bupivacaine during radical operations followed by containment of endothelial dysfunction by limiting the destructive and degenerative changes in the endothelial cell organelles, stabilization of membranes, preventing spasm of arterioles, stasis and erythrocyte sludge. Conclusion. Methods of epidural analgesia versus opioid analgesia leads to a significant reduction of the phenomena of infiltration, perivascular and interstitial edema in the composition of the intestinal wall in the area of surgical procedure. Combined techniques of low-flow sevoflurane anesthesia and epidural analgesia, followed by prolonged epidural anesthesia is an optimal method of anesthesia protection of patients from operating aggression during surgical treatment of colorectal cancer.

Optimization of anesthetic management of surgical treatment of colorectal cancer. Part II: morphological aspects.

Background. Interest in the study of the properties of sevoflurane, increased in recent years due to its influence on hemodynamics and morphological condition of the respiratory department of lungs, causes advisability of analyzing the structure of organs directly involved in the reactions of radical surgery for colorectal cancer. Objective. The purpose of the study is comparative analysis of tissue and cell ultrastructure in intraoperative biopsies of the colon in the conditions of application of the standard ataralgesia and combined anesthesia with epidural analgesia. Methods. It was performed a comparative analysis of morphological data of the colon using total intravenous anesthesia followed analgesia with opiates analgesics, and combined techniques using low-flow sevoflurane anesthesia and epidural analgesia, followed by prolonged epidural anesthesia. Results. The central link in the development of pathological changes in the colon wall at anesthesiology maintenance of surgical interventions in the treatment of colorectal cancer is the system of microcirculation. In carrying out radical intervention on the background of the standard total ataralgesia distrophic and destructive changes of endothelial cells organelles cause endothelial dysfunction expressed in microvessels and tissue displays considerable microcirculatory disorders apply to all shell wall of the colon near the affected area of colorectal. Combined low-flow sevoflurane inhalation anesthesia and epidural analgesia with bupivacaine during radical operations followed by containment of endothelial dysfunction by limiting the destructive and degenerative changes in the endothelial cell organelles, stabilization of membranes, preventing spasm of arterioles, stasis and erythrocyte sludge. Conclusion. Methods of epidural analgesia versus opioid analgesia leads to a significant reduction of the phenomena of infiltration, perivascular and interstitial edema in the composition of the intestinal wall in the area of surgical procedure.

Effects of Low-Flow Sevoflurane Anesthesia on Pulmonary Functions in Patients Undergoing Laparoscopic Abdominal Surgery

Objective. The aim of this prospective, randomized study was to investigate the effects of low-flow sevoflurane anesthesia on the pulmonary functions in patients undergoing laparoscopic cholecystectomy. Methods. Sixty American Society of Anesthesiologists (ASA) physical status classes I and II patients scheduled for elective laparoscopic cholecystectomy were included in the study. Patients were randomly allocated to two study groups: high-flow sevoflurane anesthesia group (Group H, n = 30) and low-flow sevoflurane anesthesia group (Group L, n = 30). The fresh gas flow rate was of 4 L/min in high-flow sevoflurane anesthesia group and 1 L/min in low-flow sevoflurane anesthesia group. Heart rate (HR), mean arterial blood pressure (MABP), peripheral oxygen saturation (SpO2), and end-tidal carbon dioxide concentration (ETCO2) were recorded. Pulmonary function tests were performed before and 2, 8, and 24 hours after surgery. Results. There was no significant difference between the two groups in terms of HR, MABP, SpO2, and ETCO2. Pulmonary function test results were similar in both groups at all measurement times. Conclusions. The effects of low-flow sevoflurane anesthesia on pulmonary functions are comparable to high-flow sevoflurane anesthesia in patients undergoing laparoscopic cholecystectomy.

Optimization of anesthetic management of peri- and postoperative period in patients under surgical treatment of colorectal cancer. Part I.

Background. At the present stage of medicine development colorectal cancer is an actual medical and socio-economical problem. Because surgical is the primary method of treatment the question of how does method of anesthesia and postoperative analgesia influence on the processes of metastasis and survival of cancer patients becomes relevant. Objective. The purpose of research is to select the optimal method of anesthesia protection of patients from operating aggression during surgical treatment of colorectal cancer. Methods. It was performed a comparative analysis of clinical data and results of treatment using total intravenous anesthesia followed analgesia with opiates analgesics, and combined techniques using low-flow sevoflurane anesthesia and epidural analgesia, followed by prolonged epidural anesthesia. Results. It was shown a significant advantage of combined techniques in comparison with total intravenous anesthesia due to: normodynamic type of hemodynamics during operation, possibility to extubate patient in operating room, effective analgesia in early postoperative period. Methods of prolonged epidural analgesia provided a significant need reduction for opioid analgesics, efficient analgesia in postoperative period, saved anti-tumor immunity and resistance to metastasis in patients with cancer, has provided more early resumption of intestine motor function, reduced terms of patient's staying in the intensive care unit. Implemented methodology reduced the frequency of postoperative mortality, complications, average length of hospital stay and frequency of patient returns to intensive care unit. Conclusion. Combined techniques of low-flow sevoflurane anesthesia and epidural analgesia, followed by prolonged epidural anesthesia is an optimal method of anesthesia protection of patients from operating aggression during surgical treatment of colorectal cancer.

Effects of low-flow sevoflurane anesthesia on renal function in low birth weight infants.

BackgroundLow-flow sevoflurane anesthesia has been shown to influence renal function in rats, but not in adult humans. Presently, no study has assessed the effects of sevoflurane on renal function in low birth weight infants. Our aim was to study the renal function in low birth weight infants undergoing surgery with low-flow sevoflurane anesthesia.MethodsForty infants graded as American Society of Anesthesiologists (ASA) grade I or II undergoing abdominal surgery were selected. After the induction of anesthesia, they received sevoflurane semi-closed inhalation anesthesia with an oxygen flow rate of 1 L/minute. According to patient vital signs, in-tidal sevoflurane concentration was maintained at 2.5%–4.0%. Peripheral vein blood samples and urine specimens were obtained before surgery (T0), at the end of surgery (T1), and 24 (T2), 48 (T3), and 72 hours (T4) after surgery. Serum creatinine (Cr), blood urea nitrogen (BUN), urinary retinol binding protein (RBP), and β-N-acetyl-glucosaminidase (NAG) levels were determined at these time points. Also, a temperature probe was inserted into the center of a soda lime canister and temperature readings were obtained.ResultsThere were no significant differences in Cr and BUN before and after surgery (P > 0.05). However, RBP and NAG levels increased after surgery (P < 0.05), but returned to preoperative levels 72 hours (T4) after surgery. The highest soda lime temperature was 37.3 ± 3.1°C.ConclusionsLow-flow sevoflurane semi-closed inhalation anesthesia has no significant effect on the renal function of low birth weight infants.

Hemodynamic parameters of low-flow isoflurane and low-flow sevoflurane anesthesia during controlled ventilation with laryngeal mask airway.

Background:Nowadays laryngeal mask airway (LMA) is popular as one of the best choices for airway management. Low-flow anesthesia has some advantages like lower pollution, hemodynamic stability and cost effectiveness. Volatile anesthetics are widely used for anesthesia maintenance during operations. Sevoflurane has more hemodynamic stability compared to isoflurane, but there are few studies comparing the hemodynamic stabilities of these two anesthetics during controlled low flow anesthesia with LMA.Objectives:The aim of this study was to compare the effects of low-flow sevoflurane and low-flow isoflurane on hemodynamic parameters of patients through LMA.Patients and Methods:Eighty patients, scheduled for elective ophthalmic surgery, were randomly divided into two groups. After induction, an LMA with an appropriate size was inserted in all the patients and they were randomly allocated to two groups of low-flow sevoflurane (n = 40) and low-flow isoflurane (n = 40). Hemodynamic parameters (heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and Mean Arterial Pressure (MAP) were recorded at 5, 10, 15, 20, 25 and 30 minutes after the anesthesia induction.Results:The mean heart rate values were significantly less in the sevoflurane group (P value < 0.05) at 25 minutes after the surgery. The mean Blood Pressure in the isoflurane group was significantly higher compared with the sevoflurane group in 10, 20 and 30 minutes after the surgery (P values = 0.0131, 0.0373 and 0.0028, respectively). These differences were clinically unimportant because heart rate and mean blood pressure were on normal ranges.Conclusions:Seemingly, low-flow sevoflurane with LMA did not have any significant hemodynamic effect on clinical practice. Therefore, low-flow sevoflurane anesthesia with LMA might be considered in patients with short operations who need rapid recovery from anesthesia.

Incidence of PONV in Maxillofacial Surgery: Comparison of High-Flow and Low-Flow Anesthesia

Incidence of PONV in Maxillofacial Surgery: Comparison of High-Flow and Low-Flow Anesthesia Postoperative Nausea and Vomiting (PONV) still remains the “big little challenge” for anesthesiologists in their everyday practice. The aim of this study was to compare the incidence and severity of PONV, antiemetic requirement and patient satisfaction, after high-flow versus low-flow sevoflurane anesthesia without antiemetic prophylaxis.

Safety of Low Flow Sevoflurane Anesthesia for Patient with Dextrocardia and Situs Inversus Totalis: A Case Report

Introduction: Situs inversus totalis with dextrocardia also named situs inversus totalis is a rare congenital condition in which the anatomy of the abdominal and thoracic organs are arranged in a mirror image reversal of the normal positioning. Case Report: A 42-year-old Albanian female was scheduled for elective maxillofacial surgery, cyst in the left side of the neck, and previously undiagnosed dextrocardia with situs inversus was picked up in preanesthetic evaluation by an anesthesiologist, during auscultation of the heart revealed a grade 2/6 holosystolic murmur at the left parasternal border. General anesthesia was induced with propofol 3mg/kg, fentanyl 3mcg kg, rocuronium 1mg/kg to facilitate endotracheal intubation and maintained with sevoflurane 1.0- 1, 5 MAC, in O2 /N2O 50:50%. After tracheal intubation, the fresh gas flow was set to 4 L.min -1 (O 2 2 L.min, N 2O 2 L.min). When the target gas concentrations have been achieved, FGF was reduced in 1 l/min, with the relative proportion of O2 /N2O titrated to maintain the inspired oxygen fraction (FiO 2) between 0.30 and 0.35. Inhaled and exhaled gas concentrations were continuously monitored. The patient was calm after extubation (score 1-of agitation), awareness according to Awareness Categorization was pointed with score 1- no awareness. In the PACU she was hemodynamically stable and after full recovery returned to the ward. Results of arterial blood gas analyzes BUN, AST, ALT, LDH, glycemia, total bilirubin, proteinogram, haemogram and electrolytes were within normal reference range. Her postoperative course was uneventful and she was discharged on the third postoperative day. Conclusion: With particular attention in preanesthetic visit we managed to find out dextrocardia with situs inversus totalis. We realized low flow sevoflurane anesthesia, which showed to be safe.

Comparison of Effects of Low-Flow Sevoflurane and Desflurane Anesthesia on Neutrophil and T-Cell Populations

BackgroundNumerous transient effects of anesthesia on postoperative immune status have been documented in the literature. ObjectiveThis study was performed to test the hypothesis that the effects on neutrophil and T-cell populations differ with use of low-flow sevoflurane- and desflurane-induced anesthesia during abdominal surgery. MethodsFifty adult patients (American Society of Anesthesiologists physical status I or II) aged 20 to 60 years were recruited for the study. Patients were randomly assigned to one of two study groups. Anesthesia was induced using fentanyl, propofol, and vecuronium. After intubation, patients in group 1 received sevoflurane, oxygen, and nitrous oxide at a flow rate of 6 L/min, and those in group 2 received desflurane, oxygen, and nitrous oxide at a flow rate of 6 L/min. Ten minutes after induction of anesthesia, the flow rate was decreased to 1 L/min in both groups. Total leukocyte, lymphocyte, and neutrophil counts, percentage of T helper lymphocytes (CD4), cytotoxic T lymphocytes (CD8), natural killer lymphocytes, and active T lymphocyte, CD4/CD8 ratio, and plasma cortisol values were assessed before and at 2 and 24 hours after induction of anesthesia. ResultsIn the desflurane group, at 2 hours after induction of anesthesia, a significant decrease was observed in the lymphocyte count, percentage of CD4 cells, and CD4/CD8 ratio, and a significant increase was noted in the neutrophil count and percentage of CD8 cells (P < 0.05). At 24 hours after induction of anesthesia, a significant increase was observed in the leukocyte and neutrophil counts, percentage of CD4 cells, and CD4/CD8 ratio (P < 0.05). There was no change in the other parameters studied. In the sevoflurane group, a significant decrease was observed in the lymphocyte count and percentage of natural killer cells. In addition, a significant increase was noted in the leukocyte and neutrophil counts at 24 hours after induction of anesthesia (P < 0.01). The increase in the neutrophil count in the desflurane group compared with that in the sevoflurane group was statistically significant (P < 0.05). ConclusionsWith use of the low-flow anesthesia technique, compared with desflurane, sevoflurane exerts minimal effects on neutrophil and T-cell populations, which supports our hypothesis.

Low-Flow Desflurane and Sevoflurane Anesthesia Minimally Affect Hepatic Integrity and Function in Elderly Patients

Low-Flow Desflurane and Sevoflurane Anesthesia Minimally Affect Hepatic Integrity and Function in Elderly Patients

Evaluation of Recovery and Anesthetic Gas Consumption Using Remifentanil Combined with Low-Flow Sevoflurane Anesthesia in Tympanoplasty

Background: The aim of this study was to compare the effects of low-flow sevoflurane and low-flow sevoflurane supplemented with remifentanil anesthesia on the recovery time, consumption amount of the anesthetic drugs and hemodynamic differences. Materials and Methods: A prospective, randomized and double-blinded study with 50 patients was designed. Following intubation, group S received sevoflurane 1.8 vol%, oxygen, nitrous oxide at 4 l · min^–1 and normal saline continuous infusion; group SR received sevoflurane 1.2 vol%, oxygen, nitrous oxide at 4 l · min^–1 and 0.25 µg · kg^–1 · min^–1 remifentanil continuous infusions. Ten minutes after intubation the flow rates decreased to 1 l · min^–1. Consumption of each drug, postoperative recovery characteristics and visual analog scale (VAS) scores for pain were recorded. Result: There were no significant differences in hemodynamic parameters, tramadol consumption and VAS scores for pain. The patients in group SR showed faster early recovery as compared to group S. The mean consumption of sevoflurane was 18 ml in group SR, while it was 25 ml in group S. Conclusions: Low-flow sevoflurane anesthesia combined with remifentanil regimen in patients undergoing tympanoplasty surgery resulted in a faster early recovery and decreased sevoflurane consumption.

Recovery after anesthesia and anesthetic gas consumption with remifentanil combined low flow sevoflurane anesthesia for tympanoplasty surgery

Recovery after anesthesia and anesthetic gas consumption with remifentanil combined low flow sevoflurane anesthesia for tympanoplasty surgery