Anesthesia in military conflicts: towards simpler, safer, and higher standards

The increasing military activity in the Persian Gulf necessitates that anesthesiologists in the United States should gain familiarity with the use of a draw-over vaporizer attached to a non-rebreathing circuit. Unfortunately, distributors of draw-over vaporizers in the United States do not allow anesthetists to use this equipment on humans in North America when conventional anesthesia equipment is available. Since the standard of anesthesia care in the U.S. is high, the use of a draw-over vaporizer is not allowed in most settings. Hence, this article reviews the function, the advantages, and disadvantages of a draw-over vaporizer attached to a non-rebreathing circuit. The use of an oxygen concentrator is also discussed, which increases the safety of this anesthetic delivery system.