BACKGROUND: The amount and composition of fresh gas flow affect the consumption of inhalational anesthetics. The purpose of this study was to compare the enflurane consumption and economic aspects of low flow and high flow anesthesia. METHODS: Thirty patients, ASA physical status I or II, aged 20 65 yr., scheduled for gastrectomy under inhalational anesthesia, were studied. The patients were randomly assigned to one of three groups according to the fresh gas flow: O2 500 ml/min (group I); N2O 2 L/min - O2 1 L/min (group II); O2 3 L/min (group III). Anesthesia was maintained in group I by a continuous infusion of liquid enflurane into the inspiratory limb of the breathing circuit, using a syringe pump. In groups II and III, enflurane was administered by a conventional vaporizer. The cumulative dose of liquid enflurane was measured every 10 min during anesthesia. Hemodynamic parameters, inspired and expired enflurane concentrations, and enflurane consumptions were measured. RESULTS: There were no significant differences among the three groups in hemodynamic changes. The enflurane consumption was significantly less in group I than in groups II and III over time (P < 0.05). CONCLUSIONS: Low flow anesthesia offers economic advantages over high flow anesthesia.
Anesthesia* ; Anesthetics ; Enflurane* ; Extremities ; Gastrectomy ; Hemodynamics ; Humans ; Nebulizers and Vaporizers ; Respiration ; Syringes

BACKGROUND: The amount and composition of fresh gas flow affect the consumption of inhalational anesthetics. The purpose of this study was to compare the enflurane consumption and economic aspects of low flow and high flow anesthesia. METHODS: Thirty patients, ASA physical status I or II, aged 20 65 yr., scheduled for gastrectomy under inhalational anesthesia, were studied. The patients were randomly assigned to one of three groups according to the fresh gas flow: O2 500 ml/min (group I); N2O 2 L/min - O2 1 L/min (group II); O2 3 L/min (group III). Anesthesia was maintained in group I by a continuous infusion of liquid enflurane into the inspiratory limb of the breathing circuit, using a syringe pump. In groups II and III, enflurane was administered by a conventional vaporizer. The cumulative dose of liquid enflurane was measured every 10 min during anesthesia. Hemodynamic parameters, inspired and expired enflurane concentrations, and enflurane consumptions were measured. RESULTS: There were no significant differences among the three groups in hemodynamic changes. The enflurane consumption was significantly less in group I than in groups II and III over time (P < 0.05). CONCLUSIONS: Low flow anesthesia offers economic advantages over high flow anesthesia.
Anesthesia* ; Anesthetics ; Enflurane* ; Extremities ; Gastrectomy ; Hemodynamics ; Humans ; Nebulizers and Vaporizers ; Respiration ; Syringes

BACKGROUND: Intrathecal or epidural neostigmine has a postoperative analgesic effect. In this study we evaluated the effects of epidural neostigmine on postoperative analgesia and stress responses after gastrectomy. METHODS: Eighty, ASA physical status 1 or 2, patients scheduled for gastrectomy were randomly assigned to one (n = 20) of four groups. Patients received 5 ml of 0.25% bupivacaine with either saline (N0 group), neostigmine 5microgram/kg (N5 group), neostigmine 10microgram/kg (N10 group), neostigmine 15microgram/kg (N15 group) epidurally 30 minutes before operation. All patients received identical general anesthesia. Patient-controlled epidural analgesia (PCEA) was provided by bupivacaine (0.05%) and fentanyl (4 microgram/ml) for postoperative analgesia. RESULTS: The N10 and N15 groups showed reduced 24-h PCEA consumptions compared with the N0 and N5 groups (P < 0.05). No differences in visual analog pain scores at rest or during movement were observed between the groups. The concentrations of plasma cortisol, epinephrine, norepinephrine and glucose did not differ among the four groups, and their incidences of postoperative adverse effects were similar. CONCLUSIONS: Epidural neostigmine 10 and 15microgram/kg in bupivacaine produced a postoperative analgesic effect, but did not suppress stress responses after gastrectomy
Analgesia* ; Analgesia, Epidural ; Anesthesia, General ; Bupivacaine ; Epinephrine ; Fentanyl ; Gastrectomy* ; Glucose ; Humans ; Hydrocortisone ; Incidence ; Neostigmine* ; Norepinephrine ; Plasma