Journal of Clinical and Experimental Investigations

Abstract

Objective: In this study, it was aimed to investigate the hemodynamic effects of sevoflurane in low flow anesthesia (LFA) without nitrous oxide.
Methods: A total of 40 ASA I-II patients aged between 18-70 years were included in this study. Patients were randomly allocated to two groups. Group 1 (LFA with nitrous oxide) was applied preoxygenation with 10 L/min 100% O₂ for 2 min. After preoxygenation, 4-7 mg/kg pentothal, 0.1 mg/kg vecuronium bromide and 1 μg/kg fentanyl were applied respectively via intravenous route. Endotracheal intubation was applied 3 min later after induction. 4 L/min (50% O₂-50% N₂O) normal flow had been applied within the first 10 min of the operation following intubation, it was switched to 1 L/min (50% O₂-50% N₂O) low flow. Sevoflurane concentration was set as 0.8-1 MAK so as to keep mean blood pressure (MBP) within ± 20% limits. In Group 2 (LFA without nitrous oxide) all procedure was the same with Group I except that air was used instead of N₂O. Heart rate (HR), MAP, SPO₂ and ETCO₂ values were recorded just after intubation and following 15, 30, 45 and 60. min and switched to 4 L/min of normal flow 15 min before termination of the operation.
Results: There were no significant differences between the groups from measurement after induction to 60 min measurement in terms of systolic blood pressure (SBP) and ETCO₂. Values in Group I were found greater than those in Group II at 15 min measurement in terms of diastolic blood pressure (DBP), MAP and HR (p<0,05). No complications were encountered in patients.
Conclusion: We concluded that preferring LFA techniques applied without N₂O, with sevoflurane is beneficial if proper conditions are provided