title: Control of the haemodynamic response to surgical stimuli in semi-closed circuit or closed circuit anaesthesia using a multifunctional anaesthesia system.
abstract: This study compared the ability of the Zeus multifunctional anaesthesia system to control haemodynamic response to surgical stimulation in semi-closed (SCA) or closed circuit anaesthesia (CCA) modes. Fifty patients undergoing gynaecological surgery were randomly assigned to SCA or CCA. Anaesthesia was induced with 2 mg propofol and 0.9 mg/kg rocuronium, intravenously, and maintained using sevoflurane (minimum alveolar concentration [MAC], 1.0) using 2 l/min oxygen plus 2 l/min nitrous oxide (SCA 4 l/min group) or 50% oxygen plus 50% nitrous oxide (CCA group). An increase in mean arterial pressure (MAP) > 20% above baseline in response to surgical stimulation provoked a stepwise increase in sevoflurane (1.3 MAC and then 1.6 MAC), followed by fentanyl 1 pg/kg intravenously (rescue drug). The time required for MAP to return to within 10% of baseline was significantly shorter in the CCA group (6.4 +/- 3.6 min) compared with the SCA 4 l/min group (10.2 +/- 6.0 min). The percentage of patients requiring fentanyl was significantly greater in the SCA 4 l/min group than in the CCA group. In conclusion, CCA controlled acute haemodynamic responses to surgical stimuli more successfully and rapidly than SCA 4 l/min, using a multifunctional anaesthesia machine.
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Korea University Anam Hospital, Seoul, Republic of Korea.
authors.forename: S U
authors.initials: SU
authors.lastname: Choi
authors.forename: H W
authors.initials: HW
authors.lastname: Shin
authors.forename: H I
authors.initials: HI
authors.lastname: Jung
authors.forename: J Y
authors.initials: JY
authors.lastname: Park
authors.forename: S Z
authors.initials: SZ
authors.lastname: Yoon
authors.forename: Y S
authors.initials: YS
authors.lastname: Lee
authors.forename: W Y
authors.initials: WY
authors.lastname: Kim
authors.forename: S H
authors.initials: SH
authors.lastname: Chang
mesh_terms: D000328:Adult; D000764:Anesthesia, Closed-Circuit; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects*; D005260:Female; D013509:Gynecologic Surgical Procedures; D006439:Hemodynamics; D006801:Humans; D008738:Methyl Ethers / Q000008:administration & dosage*; D008875:Middle Aged; D011379:Prognosis; D000077149:Sevoflurane; D055815:Young Adult
chemical_list: D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane