[Reduced gas-flow inhalation anesthesia in traumatology and orthopedics]

Whether reduced gas-flow inhalational anesthesia using sevorane might be used in traumatological and orthopedic care was studied. A hundred and thirty-six reduced gas-flow anesthetic aids were applied. These included 41 aids during high risk surgical interventions (ventral spondylodesis under artificial pneumothorax; two-stage surgical interventions in thoracic and thoracolumbar injuries; total knee joint endoprosthesis, corrective osteotomy and synthesis in limb fractures), 66 aids during moderate-risk ones (transpedicular fixation, total hip joint endoprosthesis, intervertebral herniotomy), and 30 aids during low-risk ones (interbody spondylodesis in cervical spinal injuries, hardware removal, arthroscopy, etc.). Under low-flow anesthesia, the parameters of oxygenation, gas exchange, respiratory function, and hemodynamics were beyond the normal physiological values. The developed procedure makes it possible to employ reduced gas-flow inhalational anesthesia using sevorane at the maximum allowable concentration of 0.8 for traumatological and orthopedic operations. The use of sevorane for anesthetic maintenance reduces a pharmacological load on the patient's homeostasis and the synergism with a central analgesic (fentanyl) and a myorelaxant diminishes both a stress-induced response to surgical aggression and an anesthetic agent. Reduced gas-flow anesthesia promotes the exclusion of intraoperative cold gas cooling that is typical of high-flow anesthesia. It is necessary to continue studies to comparatively analyze the consumables in compliance with the requirements for the quality of high-technology surgical interventions since the application of high-grade disposable consumables reduces airway microbial contamination, the time of disinfection of anesthesia-monitoring apparatuses and the consumption of disinfectant agents.