Comparison of the effects of low and normal flow sevofluran anesthesia on blood water parameters, hemodynamic parameters and compilation criteria in child patients under general anesthesia

Objective: The primary goal of our study was to investigate the effects of normal and low-flow anesthesia applications on blood gas parameters, hemodynamic parameters, and the awakening process in pediatric patients. Material-Method: Our study included 56 patients and was planned as a randomized controlled trial. The patients were randomly divided into two groups. The first group was the low-flow Sevoflurane group (n=29), and the second was the normal flow Sevoflurane group (n=27). The end of anesthesia was determined as the start of the recovery process. The time of spontaneous breathing and the duration from the cessation of inhalation anesthesia to extubation were recorded as extubation time. Times for eye opening, response to verbal commands, airway sensitivity, eyelash reflex, and cough reflex were also recorded. The Modified Aldrete Recovery Scale and PAED Scale were used as recovery scales. Results: The heart rates of the patients were measured at baseline, during induction, intubation, and intraoperatively. A significant difference was found only in the values measured at the 90th minute intraoperatively (p=0.034). The mean arterial pressures of the patients were measured at baseline, during induction, intubation, and intraoperatively. A significant difference was found between the values measured at the 5th and 120th minutes intraoperatively. The end-tidal CO2 levels of the patients were measured at baseline, during induction, intubation, and intraoperatively. During both induction and intubation, etCO2 was found to be lower in Group 1. However, looking at the values measured at 20, 30, 40, 50, 60, and 90 minutes, significantly higher etCO2 was recorded in Group 1. The pH values of the patients were significantly higher in Group 2 both at the 2nd and 4th hours postoperatively. Lactate levels were found to be higher in all measurements in Group 1. While no significant difference was found in the PAED scores measured at the 5th and 10th minutes, a significantly higher PAED score was found in Group 1 at the 15th minute. Significantly higher Modified Aldrete scores were found in all measurements in Group 1. No correlation was found between anesthesia duration, surgical duration, MAS, and PAED. A significant negative correlation was found between PAED and MAS scores in all measurements when all patients were considered. Looking at the Aldrete and PAED scores at the 15th minute, a negative correlation was present in both groups, but the negative correlation in Group 1 was approximately twice as strong as that in Group 2. Conclusion: The findings of our research clearly demonstrate that the use of low-flow sevoflurane contributes significantly and positively to the quality of post-anesthesia recovery.