Measurement of consumption of sevoflurane for short pediatric anesthetic procedures: Comparison between Dion's method and Dragger algorithm

Preet Mohinder Singh, Anjan Trikha, Renu Sinha, Anuradha Borle, Preet Mohinder Singh, Anjan Trikha, Renu Sinha, Anuradha Borle

Abstract

Background: The most common drugs used in an operating room are the Inhalation agents for maintenance of anesthesia yet their measurement methods during the procedure are not well-validated. Conventional methods of measuring the vaporizer weight after each use suffers from practical limitations of high error and time constraints.

Aims: We compared two alternative methods available (Dion's method and Drager Inc. patent protocol) for their degree of concordance and correlation in real-time consumption of sevoflurane for pediatric procedures.

Results: Both methods showed a very strong correlation (0.895 [P > 0.001]). Dion's method underestimated consumption by 2.59 ml with limits of agreement between 5.188 ml and -0.008 ml. Both test results showed a strong correlation, but poor concordance.

Conclusions: Dion's method strongly correlates with Drager protocol although concordance between the two methods for measuring anesthetic gas consumption is poor. Dion's method underestimates the consumption and with slight modification addressing this underestimation, it can be electronically incorporated in other workstations to overcome limitations of real-time measurement of inhalation agent consumption.

Keywords: Dion's equation; Drager workstation; measuring inhalation agent consumption; sevoflurane consumption.

Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Histogram showing the distribution of difference of two methods (48 of 100 patients had a difference between 2 ml and 4 ml of sevoflurane)
Figure 2
Figure 2
Scatter graph-showing correlation between the two methods. Spearman's Coefficient (0.895)
Figure 3
Figure 3
Width (Px): 1201, height (Px): 1038 color depth: Bland and Altman plot between Drager algorithm and Dion's method
Figure 4
Figure 4
Comparison of median consumption among the two methods (Cases number 38, 41 consumed disproportionately high values of sevoflurane due to prolonged intravenous cannulation duration consuming more gas at higher flow and higher concentration)

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