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All Journal International Archives of Medical Sciences and Public Health
Fadhori, Rozi
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Religion Environmental Science Health Professions Medicine & Pharmacology Public Health

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LOW-FLOW VERSUS MEDIUM-FLOW ANESTHESIA: EFFECTS ON INTRAOPERATIVE PHYSIOLOGICAL PARAMETERS AND SEVOFLURANE CONSUMPTION IN ELECTIVE SURGERY A PROSPECTIVE QUASI-EXPERIMENTAL STUDY Rahmat Feryadi; Rahmi, Rahmi; Fadhori, Rozi
International Archives of Medical Sciences and Public Health Vol. 7 No. 1 (2026): International Archives of Medical Sciences and Public Health
Publisher : Pena Cendekia Insani

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53806/iamsph.v7i1.1453

Abstract

Volatile anaesthetics contribute to greenhouse gas emissions and health care costs. Low-flow anaesthesia (LFA; fresh gas flow ?1 L/min) may reduce agent consumption, but safety data in routine surgical populations, particularly in LMICs, remain limited. Objective: To compare intraoperative physiological parameters and sevoflurane consumption between LFA and medium-flow anaesthesia (MFA). Methods: In a prospective quasi-experimental study at Zainoel Abidin Regional General Hospital, Indonesia (2025), 60 ASA I-II adults undergoing elective surgery received LFA (n = 30) or MFA (n = 30; 2–4 L/min). SpO2, EtCO2, core temperature, haemodynamics, and sevoflurane consumption were measured during maintenance anaesthesia. Results: No significant differences were observed in SpO2, EtCO2, core temperature, or haemodynamic parameters (all p > 0.05). Sevoflurane consumption was significantly lower with LFA (4.02 ± 1.07 vs. 8.92 ± 1.83 mL/h), representing a 55% reduction. This remained significant after ANCOVA adjustment (adjusted mean difference-4.73 mL/h, 95% CI-6.08 to-3.38;p < 0.001) and multivariable regression (? = ?4.61, 95% CI-5.82 to-3.40; p < 0.001). Conclusion: LFA substantially reduces sevoflurane use without compromising oxygenation, ventilation, thermoregulation, or haemodynamic stability, supporting its safe, cost-effective, and environmentally responsible use in selected low-risk patients.
Co-Authors Rahmat Feryadi Rahmi Rahmi