No abstract

Humidification and heating of anaesthetic gases are desirable to prevent respiratory tract damage and a fall in body temperature during operative procedures. Numerous studies on the humidity and temperature of inspiratory gases in different breathing systems for anaesthesia have been carried out, but comparisons are difficult since different methods have been used. In this laboratory set-up we studied a non-rebreathing system with and without humidifiers and a circle absorber system with low (0.5 l/min) or medium (5 l/min) fresh gas flows regarding their ability to heat and humidify anaesthetic gases. The humidity of inspired gases was acceptable in the non-rebreathing system using either a Bennett Cascade humidifier or disposable humidifiers and in the circle absorber system using a fresh gas flow of 5 l/min or less. The temperature of the inspired gases was highest with the Bennett Cascade humidifier, followed by the low-flow circle system. The circle absorber system used with low fresh gas flow gave higher inspiratory gas temperature and humidity than the non-rebreathing system with a good disposable humidifier.

Eight harrier dogs received an i.v. infusion of halothane dissolved 1:9 in a fat emulsion for i.v. nutrition (Intralipid, Vitrum). The rate of infusion was adjusted to maintain end-tidal halothane concentrations of 0.7% and 1.4%. At 1.4%, mean arterial pressure decreased to 76 +/- 8 mmHg (10.1 +/- 1.0 kPa) (mean +/- s.e.mean) from a pre-infusion value of 122 +/- 6 mmHg (16.2 +/- 0.8 kPa) (P less than 0.01). The concomitant decrease in cardiac output was 39% and left ventricular maximum dp/dt decreased by 50% (P less than 0.01). Changes in systemic vascular resistance and pulmonary arterial pressure were small. The haemodynamic responses during halothane inhalation, to corresponding end-tidal concentrations, were similar. Arterial and mixed venous halothane concentration increased in proportion to end-tidal concentration. There were no changes in arterial PO2 during the halothane-in-fat infusion. Triglyceride concentrations in plasma increased 12-fold. Haemodynamic recovery after the infusion was fast. We conclude that the halothane-in-fat infusion caused a dose-dependent depression of myocardial contractility and arterial pressure, similar to that seen during inhalation, and that end-tidal concentration could be used for control of the infusion rate.

The costs of anaesthetic drugs, intravenous agents as well as gases, were studied for different anaesthetic techniques in a medium-sized operative procedure, cholecystectomy. Three anaesthetic breathing systems were used: a non-rebreathing system, a circle absorber system with medium fresh gas flows of 3-6 l/min, and a low-flow circle system. Anaesthesia without volatile inhalation agents used with a low-flow technique was the least expensive, and anaesthesia with isoflurane in a non-rebreathing system was the most expensive. The costs of anaesthesia without volatile inhalation agents in a non-rebreathing system, enflurane anaesthesia in a circle system with medium fresh gas flows, and isoflurane anaesthesia with low-flow technique were similar.