Anestesia e Pesquisa Clínica
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Washin of 8% Sevoflurane between Drager Fabius GS and General Electric Avance: An in Vitro Observational Study

Juan Soliveres Ripoll and Carlos Docampo Sierra

Objectives: To in vitro compare sevoflurane washin at FGF=6 l min-1, 9 l min-1 and 12 l min-1 between the General
Electric Avance® and the Dräger Fabius GS anaesthesia workstations. To know whether it is possible to reach an 8%
sevoflurane concentration at each of the FGF studied.
Methods: In this observational in vitro study, three Avance (General Electric, Helsinki, Finland) and three Fabius GS
(Dräger Medical, Lübeck, Germany) anaesthesia workstations were compared. A test lung was connected to the
anaesthesia workstation and a sampling tube was connected from the Y piece of the breathing system to a Cardiocap
S/5 gas analyser (General Electric, Helsinki, Finland). The gas analyser was connected to a computer and sevoflurane
concentration and timeline were recorded every second. Mechanical ventilation was set to 500 ml tidal volume, 12
breaths per minute and FGF (fresh gas flow) of 6, 9 or 12 l min-1. After checking a reading of 0.0 vol% of
sevoflurane, the vaporizer was opened at 8% and data were recorded for 4 minutes (FGF of 6, 9 and 12 l min-1 for
Avance and 12 l min-1 for Fabius) or 7 minutes (FGF of 6 and 9 l min-1 for Fabius)
Results: 90 test were recorded. Time to full washin was: FGF=6 l min-1: 42.30 ± 2.49 s (Avance) and 223.42 ± 13.74 s
(Fabius), p<0.001. FGF=9 l min-1: 34.86 ± 2.54 s (Avance) and 122.40 ± 5.22 (Fabius), p<0.001. FGF=12 l min-1:
29.67 ± 2.06 s (Avance) and 93.81 ± 5.93 (Fabius), p<0.001. 8% washin was only reached at FGF=6 l min-1 for Avance
and Fabius. After plateau, a decay in sevoflurane concentration was observed at all FGF except for Fabius at FGF=6 l
min-1.
Conclusion: Avance is faster than Fabius at all FGF only at FGF of 6 l min-1 can be reached the 8% sevoflurane
concentration. For high concentration sevoflurane inhalational adult anesthesia induction, it is advisable to use
FGF=6 l min-1 and to purge the circuit for at least 42.30 ± 2.49 s (Avance) or 223.42 ± 13.74 s (Fabius).