• Sunchai Theerapongpakdee, Thepakorn Sathitkamrnmanee, Sirirat Tribuddharat, Nonthida Rojanapithayakorn, Kanchana Uppan, Cattleya Thongrong, and Piyaporn Bunsangcharoen.
• J Med Assoc Thai. 2014 Nov 1;97(11):1171-6.

ObjectiveThe authors compared the baby enclosed afferent reservoir (Baby EAR) with the Jackson-Rees (JR) anesthesia circuit for the minimal fresh gas flow (FGF) requirement with no and clinically acceptable rebreathing in spontaneous breathing anesthesia among pediatric patients.Material And MethodThe present study was a randomized crossover study. Twenty patients, weighing 5 to 20 kg with ASA physical status I-II were enrolled. They were allocated to group 1 (EAR-JR) starting with Baby EAR then switching to JR or group 2 (JR-EAR), reversedpattern. After induction and intubation, anesthesia was maintainedwith a N2O/O2 combination with sevoflurane 1 to 3% and fentanyl. Starting with the first circuit, all patients were spontaneously ventilated with FGF 500 mL/kg/min for 10 minutes, and then gradually decreased by 50 mL/kg/min every five minutes. End-tidal CO2 (ETCO) and inspired minimum CO2 (imCO) were recorded until rebreathing (imCO2 >2 mmHg) occurred and continued until rebreathing was not clinically acceptable (imCO2 >6 mmHg). The anesthesia breathing circuit was switched and the procedure repeated.ResultsThe minimal FGF at no rebreathing of Baby EAR and JR were 192.5±76.6 and 347.5±108.2 mL/kg/min; p<0.001. At acceptable rebreathing, the values were 117.5±46.7 and 227.6±90.6 mL/kg/min; p< 0. 001.ConclusionBaby EAR can be used safely, effectively, and requires less FGF than JR in pediatric anesthesia in patients weighing 5 to 20 kg.

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