Feasibility and Safety Properties of Metabolic-Flow Anesthesia Driven by Automated Gas Control<sup>®</sup> in Pediatric Patients: A Prospective Observational Study
<i>Background and Objectives</i>: Metabolic-flow (<0.35 L/min) anesthesia is practiced more often as manufacturers provide newer technologies, yet the benefits of metabolic-flow anesthesia have not been fully investigated. This study aimed to investigate the feasibility and safety of...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-04-01
|
| Series: | Medicina |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1648-9144/61/5/786 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Summary: | <i>Background and Objectives</i>: Metabolic-flow (<0.35 L/min) anesthesia is practiced more often as manufacturers provide newer technologies, yet the benefits of metabolic-flow anesthesia have not been fully investigated. This study aimed to investigate the feasibility and safety of automated gas control (AGC<sup>®</sup>) mode, which provides metabolic-flow anesthesia, in a pediatric population. <i>Materials and Methods</i>: Pediatric surgery patients between 1 and 10 years of age were included in this prospective observational trial. After intravenous induction and safe orotracheal intubation, AGC<sup>®</sup> was initiated, and total sevoflurane consumption (mL) and wash-in speed-based sevoflurane consumption data were collected to measure feasibility. For safety, inspired (F<sub>i</sub>O<sub>2</sub>), alveolar (F<sub>A</sub>O<sub>2</sub>), and expired (F<sub>E</sub>O<sub>2</sub>) oxygen concentration data, and inspired and alveolar sevoflurane (F<sub>i</sub>Sevo and F<sub>A</sub>Sevo, respectively) concentration data, were recorded. Changes in fresh gas flow (FGF) throughout the procedure and postoperative recovery data were also compared. <i>Results</i>: A total of 130 patients were eligible for this study, and 121 patients were included in the analyses; 30 patients had a wash-in speed of 4 (WI4) and 91 patients had a wash-in speed of 8 (WI8) at follow-up. The total mean sevoflurane consumption was 9.35 ± 4.93 mL for a median surgery duration of 100 min. WI8 patients consumed more sevoflurane (9.92 ± 5.08 mL vs. 7.79 ± 4.19 mL, <i>p</i> = 0.04). At the 15th and 30th minutes, the FGF dropped under minimal flow and metabolic flow limits, respectively (<i>p</i> < 0.001). The times to extubation and obeying commands were shorter in WI8 patients (8 (5–10) vs. 11 (5–15) <i>p</i> = 0.03, and 9.5 (5–10.5) vs. 13 (9–17) <i>p</i> < 0.01). <i>Conclusions</i>: Maintenance with AGC<sup>®</sup> may offer up to 40 h of anesthesia, considering that the volume of a sevoflurane bottle is 250 mL, reflecting exceptional savings compared to conventional anesthesia management. Metabolic flow anesthesia driven by AGC<sup>®</sup> is feasible and safe in pediatric anesthesia practice. |
|---|---|
| ISSN: | 1010-660X 1648-9144 |