• Tahsin Simsek, Suleyman Derman, Raghad Giuma M Kordi, Ayten Saracoglu, and Kemal Tolga Saracoglu.
• Department of Anesthesiology and Reanimation, Health Sciences University Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey. simsektahsin2017@gmail.com.
• J Clin Monit Comput. 2022 Oct 1; 36 (5): 1257-1262.

PurposeThe standard procedure for low-flow anesthesia usually incorporates a high fresh gas flow (FGF) of 4-6 L/minute during the wash-in phase. However, the administration of a high FGF (4-6 L/min) increases the inhaled anesthetic agent consumption. This study was designed to compare the sevoflurane consumption at 2 rates of flow and vaporizer concentration during the wash-in period.MethodsPatients were randomly enrolled into high FGF (HFGF) (n = 30) and low FGF (LFGF) (n = 30) groups. During the wash-in, the HFGF group received 4 L/minute FGF with a sevoflurane vaporizer setting of 2.5%, and the LFGF group received 1 L/minute FGF with a vaporizer setting of 8%. Once the wash-in was complete, anesthesia maintenance was performed with 0.5 L/min FGF with a vaporizer setting of 2.5-4.5% in both groups. The patient demographic data, bispectral index values, hemodynamic variables, wash-in time, sevoflurane consumption during the wash-in phase, and total sevoflurane consumption were analyzed.ResultsThe median sevoflurane consumption in the wash-in phase was 8.2 mL (7.1-9.3) in the HFGF group and 2.7 mL (2.2-3.1) in the LFGF group (p = 0.001). The mean total sevoflurane consumption was 17.41 ± 3.58 mL in the patients who received HFGF and 14.93 ± 3.57 mL in the LFGF group (p = 0.001). The mean wash-in completion time was 12.49 ± 2.79 min in the HFGF group and 3.35 ± 0.67 min in the LFGF group (p = 0.001).ConclusionsThe anesthetic agent consumption during the wash-in phase was approximately 3 times lower with the administration of sevoflurane at 1 L/minute FGF than the use of 4 L/minute FGF.© 2022. The Author(s), under exclusive licence to Springer Nature B.V.

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