• Christian Hönemann, Olaf Hagemann, and Dietrich Doll.
• Department of Anaesthesia and Operative Intensive Care Medicine, St. Marienhospital Vechta, Catholic Clinics Oldenburger Münsterland, Marienstraβe 6-8, 49377 Vechta, Germany.
• Indian J Anaesth. 2013 Jul 1; 57 (4): 345-50.

AbstractDuring the inhalation of anaesthesia use of low fresh gas flow (0.35-1 L/min) has some important advantages. There are three areas of benefit: pulmonary - anaesthesia with low fresh gas flow improves the dynamics of inhaled anaesthesia gas, increases mucociliary clearance, maintains body temperature and reduces water loss. Economic - reduction of anaesthesia gas consumption resulting in significant savings of > 75% and Ecological - reduction in nitrous oxide consumption, which is an important ozone-depleting and heat-trapping greenhouse gas that is emitted. Nevertheless, anaesthesia with high fresh gas flows of 2-6 L/min is still performed, a technique in which rebreathing is practically negligible. This special article describes the clinical use of conventional plenum vaporizers, connected to the fresh gas supply to easily perform low (1 L/min), minimal (0.5 L/min) or metabolic flow anaesthesia (0.35 L/min) with conventional Primus Draeger(®) anaesthesia machines in routine clinical practice.

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