Comparison of effectiveness between gas flow 1 and 2 l.min(-1) for general anesthesia in infants and children

To determine 1) Success rate of using fresh gas flow (FGF) 1 l.min(-1) compared to 2 l.min(-1) in pediatric patients 2) Necessity of using anesthetic agent analyzer 3) predicting volatile anesthetic concentration 4) cost difference. Seventy-seven patients (age 10 days to 8 years) who underwent general anesthesia were randomly allocated into 2 groups: the control group (FGF 2 l.min(-1)) and the study group (FGF 1 l.min(-1)). Outcome measures included system leakage, SaO2, PECO2, FiO2, Fi and FeN2O, isoflurane dial setting, Fi and Fe isoflurane, isoflurane mass consumed and sodalime used. There was no difference between the groups regarding demographic data, duration of surgery and anesthesia. Success rate in using FGF 2 l.min(-1) was 100% and FGF 1 l.min(-1) was 92%. All failure cases (8%) were due to system leakage. The necessity of using a capnometer was similar at 5.3-7.7% in both groups. FiO2 was > or = 0.3 at any time. FiN2O and FeN2O were not different. Fi isoflurane was 13-15% lower than dial setting. Overall savings from using FGF 1 l/min was 37.8%. FGF 1 l.min(-1) could be safely used in most pediatric patients with lower cost. Capnometer was recommended, whereas FiO2 and Fi isoflurane could be clinically adjusted