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Automatic Gas Control Mode Versus Manual Minimal-flow and Medium-flow Anaesthesia in Breast Surgery: A Comparative
Gökhan Çeviker1, Özcan Pişkin1, Çağdaş Baytar1
1Zonguldak Bülent Ecevit University Faculty of Medicine, Department of Anaesthesiology and Reanimation, Zonguldak, Türkiye.
Turkish Journal of Anaesthesiology and Reanimation
|October 16, 2025
Summary
Automatic gas control (AGC) mode significantly reduces sevoflurane use and cost in breast surgery compared to manual methods. This anesthesia technique maintains patient hemodynamics and recovery effectively.
Area of Science:
- Anesthesiology
- Surgical Innovation
- Pharmacoeconomics
Background:
- Optimizing anesthetic agent delivery is crucial for patient safety and cost-effectiveness.
- Manual control of anesthetic gas flow requires continuous adjustment and may lead to variable consumption.
- Automatic gas control (AGC) systems offer potential for more precise anesthetic management.
Purpose of the Study:
- To compare sevoflurane consumption, cost, hemodynamic stability, and recovery profiles between AGC mode and manual anesthesia techniques.
- To evaluate the efficacy of AGC mode in elective breast surgery patients.
Main Methods:
- Ninety American Society of Anaesthesiologists I-II patients undergoing elective breast surgery were randomized into three groups: AGC, manual minimal-flow, and manual medium-flow.
- Anesthesia was maintained using sevoflurane and remifentanil infusion, with sevoflurane adjusted to maintain a bispectral index of 40-60.
- Sevoflurane consumption, cost, hemodynamic parameters (MAP, heart rate), and recovery metrics (extubation time, recovery time) were meticulously recorded and analyzed.
Main Results:
- Group AGC demonstrated significantly lower sevoflurane consumption and costs compared to both manual minimal-flow and medium-flow groups (P <0.001).
- No significant differences were observed in Mean Arterial Pressure (MAP) or recovery times among the groups (P >0.05).
- Group AGC exhibited a higher pre-extubation temperature compared to manual groups (P=0.014 and P=0.002).
Conclusions:
- Automatic gas control (AGC) mode offers a significant reduction in sevoflurane consumption and associated costs.
- AGC mode is a safe and effective alternative to manual anesthetic gas control techniques, without compromising hemodynamic stability or patient recovery.
- The findings support the adoption of AGC mode for improved efficiency and cost savings in anesthetic practice for elective breast surgery.
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