The effects of end-tidal controlled low-flow anesthesia on anesthetic agent consumption in elective surgeries: randomized controlled trial

Abstract

Purpose: The environmental impact and cost of volatile anesthetics are significant concerns in modern anesthesia. Automated end-tidal control systems aim to optimize anesthetic delivery by reducing waste and improving efficiency. This study compared the effectiveness of end-tidal controlled (EtControl) low-flow anesthesia to manually controlled (MC) low-flow anesthesia in elective surgeries. Design: A randomized controlled trial. Methods: This study was conducted with 132 ASA Class I–II patients undergoing elective surgeries under general anesthesia. Patients were randomly assigned to the EtControl (n = 66) or MC (n = 66) groups. The primary outcomes included anesthetic agent consumption (mL). Findings: Anesthetic consumption was similar between the EtControl group (17.9 ± 2.63 mL) and the MC group (18.45 ± 2.44 mL) (p = 0.07). The rate of anesthetic consumption per minute was also comparable (0.120 mL/min vs. 0.127 mL/min; p = 0.514). Conclusions: EtControl and MC methods provide comparable safety and sevoflurane consumption during low-flow anesthesia. However, EtControl reduces manual adjustments, enhancing workflow efficiency and cost-effectiveness, with potential implications for reducing environmental impact.