low flow anesthesia

With a growing need for healthcare facilities and clinicians to work in a cost-effective and eco-friendly way, adopting a low flow anesthesia method can provide several advantages worth examining. The benefits include financial, environmental, and safety advantages for both patients and clinicians.

Anesthesia plays a vital role in a patient’s surgical care pathway. The primary function of anesthesia is to help surgeons mitigate their patient’s pain during an operation. An anesthesia machine is a pneumatic device that supplies a mixture of oxygen, gas, and anesthetic agents to patients, allowing them to remain unconscious but breathing during surgery.

Most anesthesia machines feature breathing circuits. The breathing circuits deliver the essential gases to a patient and eliminate exhaledCO2. Today, most anesthesia machines feature a circle rebreathing system, the most popular breathing system in the US1. Circle circuits remove the CO2 exhaled by the patient and allow the rebreathing of the exhaled anesthetic gases.

Adopting a low flow anesthesia protocol allows clinicians to use less anesthesia agent, one of the most expensive costs of the operating room (OR), by recycling or using less of the agent. The result is not only environmental “Green OR” benefits and cost savings but added patient and clinician safety.

What Is Low Fresh Gas Flow/Low Flow Anesthesia?

Low flow anesthesia – also known as low flow ventilation or low fresh gas flow – refers to minimizing the amount of anesthetic agent used when giving a patient general anesthesia. A term frequently used to describe reduced fresh gas flows, low flow anesthesia enables gas conservation by using the lowest flow required to attain the desired balance between the exchange rate of fresh gas and anesthesia agent.

How To Perform Low Flow Anesthesia

Vaporizers add precise amounts of anesthetics to the gas flow within a breathing system. In most machines, the total gas flow enters the vaporizer, splitting the fresh gas into a carrier gas and a bypass gas. The carrier gas receives the anesthetic agent and then meets back up with the bypass gas before entering the patient’s breathing circuit. Operators can control the ratio of the split to decrease or increase the gas concentration, thus controlling the amount of anesthetic a patient will receive. With a low flow anesthesia approach, the sample gas is recycled from the anesthesia machine back into the breathing system, improving agent cost savings by reducing the amount of fresh gas and agent used.  

low flow anesthesia process

The A-Series Advantage Optimizer

For clinicians and environmentally conscious facilities striving for a greener OR, low flow anesthesia helps medical professionals practice cost containment while also improving their environmental footprint, making this investment advantageous for many reasons. The Optimizer™ facilitates low flow anesthesia with extreme precision, enabling clinicians to:

  • Manage intraoperative fresh gas dynamics
  • Visualize real-time intra-case agent usage
  • Quantify actual end of case agent consumption values 

The Optimizer monitors intra-case fresh gas and agent usage. It displays a recommended value of total fresh gas to ensure that the ventilator provides an efficient level of fresh gas. This prevents breathing system depletion and minimizes excess fresh gas being directed to the scavenging system.

Optimizer

Low Flow decision support tool can advise clinicians on how to use lower fresh gas flows and reduce the amount of agents used during a case.

flow pause anesthesia

Flow Pause

Flow Pause prevents unnecessary leakage of anesthetic gases into the OR during intubation, suction, and other operations.

anesthesia gas usage

Agent and Gas Usage

Agent and gas measurements help the delivery of low-flow anesthesia by monitoring real-time anesthetic agent consumption during and after surgery.

anesthesia e agss system

e-AGSS System

e-AGSS monitors the scavenging flow rate, indicates abnormalities, and automatically switches off when in standby to reduce energy consumption.

Optimizer

Low Flow decision support tool can advise clinicians on how to use lower fresh gas flows and reduce the amount of agents used during a case.

flow pause anesthesia

Flow Pause

Flow Pause prevents unnecessary leakage of anesthetic gases into the OR during intubation, suction, and other operations.

anesthesia gas usage

Agent and Gas Usage

Agent and gas measurements help the delivery of low-flow anesthesia by monitoring real-time anesthetic agent consumption during and after surgery.

anesthesia e agss system

e-AGSS System

e-AGSS monitors the scavenging flow rate, indicates abnormalities, and automatically switches off when in standby to reduce energy consumption.

Along with the use of the Optimizer function, recycling sample gas helps clinicians reduce agent usage and minimize the environmental impact of exhausted inhalation agents.

Why Use Low Flow Anesthesia?

There are many clinical advantages to administering low flow anesthesia; namely, it helps reduce inhalation agent usage during anesthesia procedures. An anesthetic gas reduction strategy provides environmental, economic, patient, and clinician benefits.

By reducing the use of anesthetic gases through low flow anesthesia techniques, your facility can save money while taking a green initiative. However, the advantages of low flow go far beyond financial and environmental, as proper administration can also benefit the health of patients and clinicians alike. Adhering to lower levels of gas reduces air pollution and related hospital expenditures and helps ensure the safety of both patients and staff.

The Mindray Difference

Today, clinicians are facing issues not seen before, and the emphasis on patient and clinician safety has never been higher. Our mission to advance medical technologies to make healthcare more accessible is relevant now more than ever. We are excited to introduce innovative technologies to maximize patient safety, help improve patient outcomes, complement clinical workflow, and increase efficiency in the Operating Room.

At Mindray, we realize protecting your investment is of utmost importance. We are proud to offer our Industry Leading 3-Year Warranty Coverage on all our products. Our anesthesia workstations provide cost-effective solutions that complement your clinical workflow while reducing your carbon footprint.

Explore Mindray Anesthesia

References:

  1. Michael P. Dosch CRNA Ph.D., Darin Tharp CRNA MS. “Delivery: Breathing Circuits.” Anesthesia Gas Machine- Breathing Circuits, Apr. 2021.
  2. Miller RD, eds. Anesthesia, 5th ed., Ch. 4, pp 74-95. Churchill Livingstone.,1999.
  3. Edmonds, Alicia, et al. “Evidence-Based Project: Cost Savings and Reduction … – Aana.” American Association of Nurse Anesthesiology., Feb. 2021.
  4. Hospital anesthetic gas discharges and the environment: prevent the vent. Canadian Centre for Pollution Prevention Web site. Accessed November 10, 2010.
  5. Paone, Joe. “The Benefits of Low-Flow Anesthesia.” Acron, Outpatient Surgery, November 16, 2021.