Work

Automatic Gas Control Mode Versus Manual Minimal-flow and Medium-flow Anaesthesia in Breast Surgery: A Comparative Study

Year: 2025

Type: article

Study designs: Randomized Controlled Trial, Clinical Trial

Abstract: Objective: This study compared automatic gas control (AGC) mode with manual minimal-flow and manual medium-flow techniques in elective breast surgery, evaluating sevoflurane consumption, cost, hemodynamics, and recovery. Methods: Following ethics approval, 90 American Society of Anaesthesiologists I-II patients (age 18-65 years) undergoing elective breast surgery were randomized to AGC mode (Group AGC, n = 30), manual minimal-flow control (Group ManCo, n = 30), or manual medium-flow control (Group ModFA, n = 30). All received standard induction after preoxygenation, with maintenance via sevoflurane and remifentanil infusion in a mixture of oxygen and medical air. After reaching a minimum alveolar concentration of 1.0, sevoflurane was adjusted to maintain a bispectral index of 40-60. Mean arterial pressure (MAP), heart rate, peripheral capillary oxygen saturation, bispectral index, inspired sevoflurane fractions and expired sevoflurane fraction, end-tidal carbon dioxide, temperature, and instantaneous sevoflurane consumption were recorded pre-induction and every 15 minutes. Extubation time, recovery time, surgery duration, and total anaesthesia time were documented. Total sevoflurane consumption and cost were calculated postoperatively. Results: <0.001). Conclusion: AGC mode significantly reduces sevoflurane consumption and cost compared to both manual minimal-flow and manual medium-flow techniques, without adversely affecting hemodynamics or recovery.

Source: Türk anesteziyoloji ve reanimasyon derneği dergisi

DOI: 10.4274/tjar.2025.252143