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| Image 1: Minimal FGF on the FLOW-i anesthesia delivery system |
In this months Canadian Journal of Anesthesia authors of the article "Brief Review: Theory and Practice of Minimal Fresh Gas Flow Anesthesia", conclude that with newer anesthesia delivery systems that using minimal fresh gas flow and third generation of inhaled anesthetic agents is a safe technique with many benefits [1].
The authors review advantages, potential limitations, and safety considerations when utilizing minimal fresh gas flow technique (mFGF).
- Maintaining temperature and humidity.
- Cost savings regarding inhaled anesthetic agents (see "Save $200,000" for a case study).
- Decrease in environmental exposure to anesthetic agents.
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| Image 2: Example of a patient's temperature maintained during minimal flow anesthesia. |
Potential Limitations mFGF
- Leaks in the circle system- This is highly monitored in newer devices with the system checkout and feedback alarms.
- CO2 absorbency & desiccation- new soda lime contains 0% potassium hydroxide (KOH) a known alkali that results in carbon monoxide production.
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| Image 3: Example of a system check out, checking for leaks (highlighted in yellow). |
Safety considerations with mFGF
Patient monitoring- newer devices have precise gas analyzers which monitor both inhaled and exhaled anesthetic gas.
A few machines have an additional gas analyzer which can safely turn off the vaporizer, preventing a over dose of anesthetic agent.
Reference
[1]. Brattwell et. al. (2012). Brief Review: Theory and Practice of Minimal Fresh Gas Flow Anesthesia. Canadian Journal of Anesthesia. 59 (8): 785-797.
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