Low‐flow anaesthesia

Summary Although many anaesthesia machines are equipped with circle rebreathing systems, inhalational anaesthesia remains frequently performed using relatively high fresh‐gas flows. The major advantages of rebreathing techniques can be achieved only if the fresh‐gas flow is reduced to 1 l.min ‐1 or less. Although there are potential risks associated with low‐flow anaesthesia, modern anaesthesia machines meet all the technical requirements for the safe use of low‐flow techniques if they are used in conjunction with equipment for monitoring inhaled and exhaled gas concentrations; these monitors are already increasingly available and, in the near future, are likely to become an obligatory safety standard in many countries. For both economic and ecological reasons, the use of new inhalational anaesthetics, with low tissue solubility and low anaesthetic potency, can be justified only if the efficiency of administration is optimised by using low‐flow anaesthetic techniques.