Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-745bb68f8f-cphqk Total loading time: 0 Render date: 2025-01-15T10:18:47.509Z Has data issue: false hasContentIssue false

Chapter 3 - Anesthesia Equipment: Clinical Considerations

Published online by Cambridge University Press:  24 May 2023

By
George Mychaskiw ,
Eric Ly ,
Austin Ly ,
Kelsey Rooney ,
Leah A. Kaplan ,
Stephen Patin ,
Victoria L. Lassiegne ,
Katherine C. Babin ,
George Thomas  and
Elyse M. Cornett
...Show all authors
Edited by
Alan David Kaye  and
Richard D. Urman
Alan David Kaye
Affiliation:
Louisiana State University School of Medicine
Richard D. Urman
Affiliation:
Brigham and Women’s Hospital, Boston
Get access

Summary

The anesthesia workstation, commonly referred to as the “anesthesia machine,” is a complex and very specialized piece of equipment that is relatively unique in medical practice. It is, in essence, a device to control the delivery of medical gases to patients, including oxygen, air, nitrous oxide, and volatile anesthetics, along with a specialized ventilator adapted to operating room conditions. The safe use of the anesthesia workstation requires proper training, preuse checkout, and continuous monitoring of its function. The medical literature is replete with examples of patient harm from inappropriate use of the anesthesia workstation and from mechanical or electrical failure of its components. Additionally, volatile anesthetics, while valuable in medical practice, have a very low therapeutic index and manifest severe, and even fatal, side effects when administered improperly. Finally, many patients under general anesthesia are paralyzed for surgery and ventilated through an endotracheal tube. Their safety is completely dependent on the anesthesia professional’s use of the anesthesia workstation to deliver breathing gases, remove carbon dioxide from exhaled gas, and precise administration of volatile anesthetics.

Type
Chapter
Information
Cambridge Handbook of Anesthesiology , pp. 41 - 59
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Davey, AJ, Diba, A, Ward, CS, eds. Ward’s Anaesthetic Equipment, 6th ed. Edinburgh: Elsevier; 2011.Google Scholar
Sinclair, CM, Thadsad, MK, Barker, I. Modern anaesthetic machines. Contin Educ Anaesth Crit Care Pain. 2006;6(2):75–8.Google Scholar
Dorsch, JA, Dorsch, SE. Understanding Anesthesia Equipment, 5th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2008.Google Scholar
Ehrenwerth, J, Eisenkraft, J, Berry, J. Anesthesia Equipment: Principles and Applications, 3rd ed. Philadelphia, PA: Elsevier; 2020.Google Scholar
Gurudatt, C. The basic anaesthesia machine. Indian J Anaesth. 2013;57(5):438.CrossRefGoogle ScholarPubMed
Butterworth, JF, Mackey, DC, Wasnick, JD. Chapter 4. The anesthesia machine. In: Butterworth, JF, Mackey, DC, Wasnick, JD, eds. Morgan & Mikhail’s Clinical Anesthesiology, 5th ed. New York, NY: McGraw Hill; 2013. Available from: https://accessmedicine.mhmedical.com/content.aspx?aid=57230318.Google Scholar
Cowles, CE. Chapter 2. The operating room environment. In: Butterworth, JF, Mackey, DC, Wasnick, JD, eds. Morgan & Mikhail’s Clinical Anesthesiology, 5th ed. New York, NY: McGraw Hill; 2013. Available from: https://accessmedicine.mhmedical.com/content.aspx?aid=57230046.Google Scholar
Caplan, RA, Vistica, MF, Posner, KL, Cheney, FW. Adverse anesthetic outcomes arising from gas delivery equipment. Anesthesiology. 1997;87(4):741–8.CrossRefGoogle ScholarPubMed
Brockwell, RC, Andrews, JJ. Complications of inhaled anesthesia delivery systems. Anesthesiol Clin North Am. 2002;20(3):539–54.CrossRefGoogle ScholarPubMed
Patil, VP, Shetmahajan, MG, Divatia, JV. The modern integrated anaesthesia workstation. Indian J Anaesth. 2013;57(5):446–54.Google ScholarPubMed
Thompson, PW, Wilkinson, DJ. Development of anaesthetic machines. Br J Anaesth. 1985;57(7):640–8.CrossRefGoogle ScholarPubMed
Hendrickx, JFA, De Wolf, AM. The anesthesia workstation: quo vadis? Anesth Analg. 2018;127(3):671–5.CrossRefGoogle ScholarPubMed
Butterworth, JF, Mackey, DC, Wasnick, JD. Chapter 3. Breathing systems. In: Butterworth, JF, Mackey, DC, Wasnick, JD, eds. Morgan & Mikhail’s Clinical Anesthesiology, 5th ed. New York, NY: McGraw Hill; 2013. Available from: https://accessmedicine.mhmedical.com/content.aspx?aid=57230207.Google Scholar
Butterworth, JF, Mackey, DC, Wasnick, JD. Chapter 4. The anesthesia workstation. In: Butterworth, JF, Mackey, DC, Wasnick, JD, eds. Morgan & Mikhail’s Clinical Anesthesiology, 6th ed. New York, NY: McGraw Hill; 2018. Available from: https://accessmedicine.mhmedical.com/content.aspx?aid=1161425729.Google Scholar
Das, S, Chattopadhyay, S, Bose, P. The anaesthesia gas supply system. Indian J Anaesth. 2013;57(5):489–99.CrossRefGoogle ScholarPubMed
Petty, C. Understanding your machine: O2 flush valve key to safety. Anesthesia Patient Safety Foundation. 1993. Available from: www.apsf.org/article/understanding-your-machine-o2-flush-valve-key-to-safety/.Google Scholar
Mun, SH, No, MY. Internal leakage of oxygen flush valve. Korean J Anesthesiol. 2013;64(6):550–1.CrossRefGoogle ScholarPubMed
Dosch, MP, Tharp, D. The anesthesia gas machine. 2021. Available from: https://healthprofessions.udmercy.edu/academics/na/agm/04.htm.Google Scholar
Anesthesia Key. The anesthesia machine. 2017. Available from: https://aneskey.com/the-anesthesia-machine-5/.Google Scholar
Butterworth, JF, Mackey, DC, Wasnick, JD. Chapter 3. Breathing systems. In: Butterworth, JF, Mackey, DC, Wasnick, JD, eds. Morgan & Mikhail’s Clinical Anesthesiology, 6th ed. New York, NY: McGraw Hill; 2018. Available from: https://accessmedicine.mhmedical.com/content.aspx?aid=1161425570.Google Scholar
Goneppanavar, U, Prabhu, M. Anaesthesia machine: checklist, hazards, scavenging. Indian J Anaesth. 2013;57(5):533–40.CrossRefGoogle ScholarPubMed
Cowles, CE Jr. The operating room environment. In: Butterworth, JF, Mackey, DC, Wasnick, JD, eds. Morgan & Mikhail’s Clinical Anesthesiology, 6th ed. New York, NY: McGraw Hill; 2018. Available from: https://accessmedicine.mhmedical.com/content.aspx?aid=1161425482.Google Scholar
Parthasarathy, S. The closed circuit and the low flow systems. Indian J Anaesth. 2013;57(5):516–24.CrossRefGoogle ScholarPubMed
Kim, J, Kang, D, Lee, H, Ryu, S, Ryu, S, Kim, D. Change of inspired oxygen concentration in low flow anesthesia. Anesth Pain Med (Seoul). 2020;15(4):434–40.Google ScholarPubMed
Becker, DE, Rosenberg, M. Nitrous oxide and the inhalation anesthetics. Anesth Progr. 2008;55(4):124–31.CrossRefGoogle ScholarPubMed
Venkatachalapathy, R, Cherian, A, Panneerselvam, S. Changes in gas composition during low flow anaesthesia without nitrous oxide. J Clin Diagn Res. 2017;11(7):UC29–33.Google ScholarPubMed
Banks, A, Hardman, JG. Nitrous oxide. Contin Educ Anaesth Crit Care Pain. 2005;5(5):145–8.CrossRefGoogle Scholar
Baum, JA. The carrier gas in anaesthesia: nitrous oxide/oxygen, medical air/oxygen and pure oxygen. Curr Opin Anesthesiol. 2004;17(6):513–16.Google Scholar
Agarwal, A, Singh, PK, Dhiraj, S, Pandey, CM, Singh, U. Oxygen in air (FiO2 0.4) improves gas exchange in young healthy patients during general anesthesia. Can J Anesth. 2002;49(10):1040–3.Google Scholar
Young, ER. Sedation: a guide to patient management, 4th edition. Anesth Prog. 2005;52(1):43–4.CrossRefGoogle Scholar
Schlesinger, WH. On the fate of anthropogenic nitrogen. Proc Natl Acad Sci U S A. 2009;106(1):203–8.CrossRefGoogle ScholarPubMed
Cooper, JB, Newbower, RS, Kitz, RJ. An analysis of major errors and equipment failures in anesthesia management: considerations for prevention and detection. Anesthesiology. 1984;60(1):34–42.Google Scholar
Arbous, MS, Meursing, AEE, van Kleef, JW, et al. Impact of anesthesia management characteristics on severe morbidity and mortality. Anesthesiology. 2005;102(2):257–68; quiz 491–2.Google Scholar
Merchant, R, Chartrand, D, Dain, S, et al. Guidelines to the practice of anesthesia revised edition 2013. Can J Anaesth. 2013;60(1):60–84.CrossRefGoogle Scholar
Association of Anaesthetists of Great Britain and Ireland (AAGBI); Hartle, A, Anderson, E, Bythell, V, et al. Checking anaesthetic equipment 2012: Association of Anaesthetists of Great Britain and Ireland. Anaesthesia. 2012;67(6):660–8.Google ScholarPubMed
Avante Health Solutions. GE and Drager anesthesia machines: how do they measure up? 2018. Available from: https://avantehs.com/learn/buying-guides/ge-drager-anesthesia-comparison.Google Scholar
Spaeth, J, Schweizer, T, Schmutz, A, Buerkle, H, Schumann, S. Comparative usability of modern anaesthesia ventilators: a human factors study. Br J Anaesth. 2017;119(5):1000–8.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×