Coasting: Worth the effort?

Jan F.A. Hendrickx*, S. De Cooman, A. A.J. Van Zundert, R. E.J. Grouls, E. Mortier, A. M. De Wolf

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

A new anesthesia machine incorporates a "coasting mode", but the extent to which a coasting technique can maintain anesthesia at the end of a procedure under optimal conditions (closed circuit anesthesia) remains unknown. Sixty-nine patients undergoing peripheral or abdominal surgery were assigned to 1 of 9 groups, depending on when desflurane coasting (in O 2/air) was started (after 4, 9, 16, 25, 36, 49, 64, 81, or 100 min). The end-expired desflurane concentration was maintained at 4.5% in O 2/air prior to coasting with a conventional anesthesia machine. After initiating coasting (using a closed-circuit technique), we examined when the end-expired desflurane concentration reached 70, 60, 50, and 40% of its value during maintenance (= 30, 40, 50 and 60% decrement times, respectively). Decrement times increased with increasing duration of anesthesia, and varied widely. After 64 min of maintenance anesthesia, the end-expired desflurane concentration remained at or above 70, 60, 50, and 40% of its maintenance value during 10.3 ± 2.3, 16.0 ± 3.5, 25.0 ± 5.9, and 45.4 ± 19.3 min, respectively (average ± standard deviation). Coasting can briefly maintain anesthesia towards the end of a procedure. While savings with an automated coasting mode are likely to be modest per patient, they may become substantial when multiplied by the number of procedures per day per operating room with no increase in the clinical workload of the anesthesia provider.

Original languageEnglish (US)
Pages (from-to)147-150
Number of pages4
JournalActa anaesthesiologica Belgica
Volume62
Issue number3
StatePublished - Sep 2011

Keywords

  • Closed-circuit anesthesia
  • Coasting
  • Inhaled anesthetics
  • Pharmacokinetics

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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