Abstract

Background: The routine use of low flows can cut down anesthesia costs up to 75%. The amount of volatile anesthetic agents extracted is directly proportional to the fresh gas flow (FGF) into the breathing circuit and system. The present study was conducted to determine the pattern of LFA among anesthetists.

Materials & Methods: It included 250 anesthetists. A questionnaire was prepared and was distributed among them. The questionnaire contained two parts, the first part intended to collect general information such as years of experience in anesthesia, region of practice, subspecialty of the participant if any and the practice setting of the participant. The second part dealt with questions specific to the practice of LFA, use of oxygen analysers and agent analysers, routine use of ETCO2 monitors and bispectral index (BIS) monitors, type of anesthesia machine being used routinely, preferred carrier gas and volatile agent as well as the volatile agent in routine use.

Results: Out of 250 subjects, males were 120 and females were 130. The difference was non- significant (P-0.5). The years of experience of anesthesiologists were 0-5 years (85), 6-11 years (65), 11-15 years (40), 16-20 years (20), 21-25 years (25) and >25 years (15). The difference was significant (P-0.01). Region of practice was north India (150) and south India (100). The difference was significant (P-0.05). The specialty of use was general (85), Cardiac & Vascular (60), pediatric (76), critical care (20) and other (9). Practice setting was private (160) and government (90). The difference was significant (P-0.02). The availability of workstations, scavenging systems and minimum monitoring equipment were oxygen analyzers (100), agent analyzers (30), ETCO₂ monitors (45), BIS monitors (8), work stations (55) and work stations with MAC (12). The difference was significant (P-0.02). The fresh flow rate was <0.5 L (12%), 0.5 L (15%), 0.5-1 L (32%), 1-1.5 L (13%), 1.5- 2 L (18%) and >2 L (10%). The difference was significant (P-0.05). The volatile agents used was halothane (40%), desflurane (17%), isoflurane (65%) and sevoflurane (70%). The difference was significant (P-0.01).

Conclusion: Low flow anesthesia is practiced by many anesthesiologists. There is a lack of adequate monitoring facilities and scavenging systems.

Keywords: Desflurane, Low flow anesthesia, Isoflurane.