The Effects of Fresh Gas Flow on Emergence Agitation for Gynecologic Surgery: A Clinical Study

ABSTRACT Objective: This prospective study aimed to determine whether low flow anesthesia (LFA) has an effect on emergence agitation in women who underwent laparotomic gynecologic surgeries. Method: Sixty four female patients were enrolled in this prospective randomized study. The patients were randomly allocated into two groups: Group 2 and Group 0.5. The fresh gas flow (FGF) rate was set at 4 L min-1 in both groups, initially. When all patients reached 1 minimum alveolar concentration of sevoflurane, the FGF rate was reduced to 2 L min-1 in Group 2 and 0.5 L min-1 in Group 0.5. For Group 0.5, vapor was closed 15 minutes before the end of surgery, while it was closed at the end of the operation for Group 2. At the end of the surgery, the FGF rate was increased to 4 L min-1. Emergence agitation was assessed using the Riker Sedation Agitation Scale (SAS) in the post-anesthesia care unit at 5, 10, 20 and 30th minutes. Results: Emergence agitation was observed in 5 patients, no significant difference was found between two groups. For all evaluation times, number of patients with SAS=4 was significantly higher in Group 0.5, while the number of patients with SAS<4 was significantly higher in Group 2 (p<0.05). Conclusion: The number of patients who are calm and cooperative was higher in LFA. Keywords: Emergence agitation, general anesthesia, fresh gas flow