Anesthesia Clinical Trial
Official title:
Studie Zur Evaluation Der Narkosemittel- Und Sauerstoffkonzentrationsvorhersage im Narkosegeraet Perseus-A500 Der Firma Draeger
The anesthesia machine "Draeger Perseus A 500" has an integrated software which calculates
the predicted course of the concentration of oxygen and the volatile anesthetics sevoflurane
and desflurane for the next 20 minutes.
The Goal of this study was to evaluate the accuracy of this prediction under controlled
clinical circumstances.
Therefore 20 patients undergoing an operation with general anesthesia were included. They
were assigned to a sevoflurane- or desflurane-group by lots.
The oxygen- and volatile anesthetic influx into the anesthesia machine`s circuit was adjusted
following a fixed protocol. The concentration of oxygen and the volatile anesthetic was
measured and compared to the predicted values.
In an anesthesia machine´s circuit the concentration of oxygen and volatile anesthetics
depends on many variables. Especially during low- or minimal-flow anesthesia it can be
difficult for the anesthesist to anticipate these values.
In the anesthesia machine 'Draeger Perseus A500' a software is included, which calculates and
predicts the course of the inspired and exhaled concentration of oxygen and the volatile
anesthetics sevoflurane and desflurane for the next 20 minutes. The results can be displayed
as a diagram and are based on the actual setup of the anesthesia machine.
The behavior of the oxygen-concentration depends on the oxygen-delivery on the one hand and
on the patients oxygen-consumption on the other hand. The oxygen delivery into the
anesthesia-circuit can be analysed easily and exactly. The patients oxygen-consumption cannot
be measured except invasive procedures such as a pulmonary-catheter are used. In daily
routine the oxygen-consumption can only be calculated. Different methods based on the
Brody-equation are published. In the Perseus-software a simplified formula suggested by Arndt
ist used.
The concentration-progress of volatile anesthetics depends on many factors and can be
described as a cascade of systems beginning with the influx of gas into the anesthesia
machine, the uptake or release of the anesthetic agent in the alveoli and ending with the
distribution between the different compartments and possibly the metabolisation. These
processes can be described by pharmacologic more-compartment models. In the Perseus
anesthesia machine a five-compartment model described by Bailey is used for predicting.
These two models have never before been included into the software of an anesthesia machine
an therefore never been evaluated ind such a surrounding.
For the evaluation the investigators included 20 patients from the surgical department
undergoing an operation with general anesthesia. 10 patients received sevoflurane, 10
patients desflurane.
The investigators generated stable conditions to evaluate the precision of these predictions.
Thus the investigators used a fixed protocol for the gas influx to the anesthesia machine,
the vapor adjustment and the ventilator setup. At least three periods lasting 20 minutes were
measured.
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