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Gulhane Med J. 2004; 46(4): 291-297


Comparison of Arterial Carboxyhemoglobin, Heamodynamic and Recovery Characteristics of Low Flow Desflurane and Sevoflurane Anesthesia

Dr. Ayşegül CEYLAN, Dr. Pakize KIRDEMİR, Dr. Ayla KABALAK, Dr. Cüneyt AKSU, Dr. Mustafa BAYDAR, Dr. Nermin GÖĞÜŞ.

Abstract
'In our study, we aimed to detect carboxyhemoglobine (CO) levels and recovery effects in low-flow anesthesia with desflurane and sevoflurane in patients who were performed urological surgery. ASA I-II, sixty patients between the ages 18-70 were scheduled for elective surgical procedures under general anesthesia and were randomized into two groups; Group I (Desflurane group) and Group II (Sevoflurane group). Soda-lime was replaced with the fresh one and then the patients were taken into operation room, without premedication. Electrocardiogram (EKG), (KAH), mean arterial pressure (OAB) and partial oxygen saturation (SpO2) values were recorded preoperatively. After preoxygenation with 10 L. min-1 %100 O2 for two minutes, we performed intravenous 1mg.kg-1 fentanyl, 4-7 mg. kg-1 tiyopental and 0.1 mg.kg-1 vecuronium respectively. After three minutes, we entubated the patients. After performing 4 L.dk.-1 normal flow anesthesia with %40 O2 - %60 N2O during the first 10 minutes of the operation, 1 ml.dk-1 low-flow anesthesia with %50 O2-%50 N2O was started we tried to control sevoflurane or desflurane concentrations in 0.8 MAC level and also OAB values between preoperative values ±%20 levels. Then we recorded KAH, OAB, SpO2, EtCO2 values after entubation and at 15th, 30th, 45th and 60th minutes during the operation. Also we reported arterial blood gasses and COHb values at the 30th minute of the operation and at the 60th minute of the low-flow stage. Normal flow anesthesia 4 ml.min-1 was restarted 15 minutes before the end of the operation. All anesthetical agents were stopped and 6 L.min-1 %100 O2 was given to the patients. Start of spontaneous respiration, extubation, eye-opening and vocal responses, eyelash reflex, cough reflex times and airway sensitivity were noted before the patients were sent to recovery room. Hemodynamical parameters were not significantly different between two groups. In our study we concluded that both sevoflurane and desflurane were safe agents in low-flow anesthesia procedures and hemodynamical parameters were not statistically different from each other.'

Key words: Low Flow Anesthesia, Arterial Carboxyhemoglobin



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