Abstract
Knowledge of the consumed amount of volatile anesthetic (VA) expressed in liquid agent is necessary to enable agent sparing dosing measures and for billing purposes. The widespread Draeger Primus™ anesthesia machine displays in its logbook the amount of consumed VA at the end of each anesthesia, but the reliability of this parameter is yet unknown. The objective was to evaluate the precision and reliability of the inbuilt VA consumption display in Draeger Primus™ anesthesia machines as compared with the gold standard of weighing the vaporizer before and after anesthesia. In this prospective laboratory investigation we compared the VA consumption displayed by the Draeger Primus™ anesthesia machine with measured vaporizer weight differences before and after 10 sevoflurane and 10 desflurane anesthesias. We assessed the average difference and spread of values between the predicted (displayed) and measured (control) values for VA consumption. The displayed sevoflurane consumption overestimated the measured values by 4.3 ± 5.4 ml (7.6 %). The displayed desflurane consumption underestimated the measured values by −3.5 ± 6.3 ml (6.2 %). Nine from 10 sevoflurane pairs of values and all desflurane pairs of values were within ±1.96 SD. The displayed VA consumption calculations for sevoflurane and desflurane in the Draeger Primus™ are sufficiently reliable to estimate the pharmacoeconomic impact of VA delivery during inhalational anesthesia.
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References
Rapeport D, Harper S, Flisberg P. Pharmacoeconomic viewpoints on volatile anaesthesia—“much ado about nothing?”. Anaesth Intensive Care. 2005;33:144–5.
Weinberg L, Story D, Nam J, McNicol L. Pharmacoeconomics of volatile inhalational anaesthetic agents: an 11-year retrospective analysis. Anaesth Intensive Care. 2010;38:849–54.
Hinz J, Rieske N, Schwien B, et al. Cost analysis of two anaesthetic machines: “Primus(R)” and “Zeus(R)”. BMC Res Notes. 2012;5:3.
Honemann C, Hagemann O, Doll D. Inhalational anaesthesia with low fresh gas flow. Indian J Anaesth. 2013;57:345–50.
Coetzee JF, Stewart LJ. Fresh gas flow is not the only determinant of volatile agent consumption: a multi-centre study of low-flow anaesthesia. Br J Anaesth. 2001;88:46–55.
Cotter SM, Petros AJ, Dore CJ, Barber ND, White DC. Low-flow anaesthesia. Practice, cost implications and acceptability. Anaesthesia. 1991;46:1009–12.
Eger EI 2nd. Characteristics of anesthetic agents used for induction and maintenance of general anesthesia. Am J Health Syst Pharm. 2004;61(Suppl 4):S3–10.
Loscar M, Conzen P. Volatile anesthetics. Anaesthesist. 2004;53:183–98.
Bland JM, Altman DG. Measuring agreement in method comparison studies. Stat Methods Med Res. 1999;8:135–60.
Glen J, Marshall S. Gas leak related to Draeger Primus anaesthetic machine. Anaesthesia. 2010;65:750.
Lockwood GG, White DC. Measuring the costs of inhaled anaesthetics. Br J Anaesth. 2001;87:559–63.
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Biro, P., Kneschke, O. & Theusinger, O.M. Reliability of the volatile agent consumption display in the Draeger Primus™ anesthesia machine. J Clin Monit Comput 29, 601–604 (2015). https://doi.org/10.1007/s10877-014-9639-6
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DOI: https://doi.org/10.1007/s10877-014-9639-6