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Updated: Aug 11, 2026

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Published on: September 7, 2016
Low and minimal flow inhalational anaesthesia
1Department of Anaesthesia, Ottawa University Faculty of Medicine, Ottawa General Hospital, Ontario.
Low and minimal flow anesthesia, using fresh gas flows under 1 L/min, offers significant cost savings and environmental benefits. This approach is safe and effective for modern inhalational anesthesia.
Area of Science:
- Anesthesiology
- Pharmacokinetics
- Respiratory Physiology
Background:
- Most anesthesiologists utilize high fresh gas flow rates during inhalational anesthesia.
- Low and minimal flow anesthesia involves reduced fresh gas flow rates (0.5-1 L/min and 0.25-0.5 L/min, respectively).
Purpose of the Study:
- To elucidate the pharmacokinetic behavior of low and minimal flow anesthesia.
- To describe the practical considerations for implementing low and minimal flow anesthesia techniques.
Main Methods:
- A comprehensive Medline literature search was conducted on low flow anesthesia.
- Computer-simulated anesthetic uptake models were employed to analyze pharmacokinetic data.
Main Results:
- Low/minimal flow anesthesia can eliminate the need for in-circuit humidifiers and increase inspired gas temperature.
- This technique reduces anesthetic costs by approximately 25% and minimizes environmental pollution from scavenged gases.
- Awareness of volatile anesthetic pharmacokinetics is crucial, and potential degradation of desflurane and sevoflurane must be managed.
Conclusions:
- Utilizing fresh gas flow rates below 1 L/min for anesthesia maintenance presents numerous advantages.
- Low and minimal flow anesthesia should be promoted for inhalational anesthesia with contemporary volatile agents.
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