Evaluation of an Oxford Miniature Vaporizer placed in-circuit during the maintenance phase of low-flow anaesthesia

The aim of the study was to assess Oxford Miniature Vaporizer output when mounted in-circuit during the maintenance phase of anaesthesia, using isoflurane, controlled ventilation and a fresh gas flow rate less than 1 l/min. Twenty patients of ASA Physical Status I and II were recruited from routine general surgical lists. All patients were paralysed and ventilated. An out-of-circuit isoflurane vaporiser was used during the induction period (first 20 to 30 minutes). Anaesthesia was maintained using an Oxford Miniature Vaporizer placed in-circuit, using a fresh gas flow of 500 ml/min. The end-tidal isoflurane concentration was recorded for 90 minutes at five-minute intervals using a sidestream agent analyser. Two groups were compared, with the Oxford Miniature Vaporizer dial setting at either the 0.5 mark (low output setting) or at the 1.0 mark (higher output setting). At a dial setting of 0.5, the Oxford Miniature Vaporizer produced a steady end-tidal isoflurane of 0.63% (95% confidence interval 0.60 to 0.66). However, when the dial was turned to 1.0 the output was almost always excessive and had to be reduced. These findings indicate that a stable, predictable and clinically useful output can be achieved when the Oxford Miniature Vaporizer is positioned in-circuit using low-flow and controlled ventilation.