Bibliometric Analysis of 30 Years of Scientific Publications Related to Low-Flow Anesthesia

Background: This study aims to conduct an analysis of the literature on low-flow anesthesia published over the past 30 years, identifying the most productive countries, institutions, authors, and journals; uncovering the intellectual structure of the field through the most influential publications, authors, and journals; and visualizing thematic clusters and evolving research trends based on keyword analyses. Methods: This retrospective bibliometric study analyzed scientific publications on low-flow anesthesia indexed in the Science Citation Index Expanded (SCIE) of the Web of Science Core Collection (WoSCC) between 1993 and 2024. Articles were classified by countries, institutions, journals, and researchers, and the number of studies and citations were determined. Co-citation analysis and keyword co-occurrence analysis were performed to map thematic clusters and intellectual structures. Results: A total of 260 articles met the inclusion criteria. The United States led with 39 publications, followed by Turkey (33) and Japan (27). The most productive institution was Northwestern University (USA), and the most published journal was Anesthesia & Analgesia. The most prolific authors were André M. De Wolf and Jan F. A. Hendrickx, while co-citation analysis identified Edmund I. Eger II and Hiromichi Bito as the most influential authors based on centrality metrics. MDS and trend topic analyses revealed prominent keywords including "closed loop", "remifentanil", "sevoflurane", "bispectral index", "EEG analysis", "pharmacokinetics", "absorbent", "performance", and "FGF" (fresh gas flow). Conclusions: The United States leads the field of low-flow anesthesia in both publication count and citations. Trending terms such as "closed loop," "performance," "remifentanil," "sevoflurane," "bispectral index," "EEG analysis," "FGF," and "absorbent" reflect the current research directions in this field.