Miller Anestesia

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Impacto del circuito de anestesia
El circuito de anestesia puede limitar la velocidad de recuperación,
igual que limita la inducción. Si no se desconecta al paciente del
circuito al acabar el suministro de anestésico, el paciente puede
continuar inspirando anestésico. Para reducir la concentración ins-
pirada a cero o casi cero hay que tener en cuenta dos factores: lavar
el anestésico dentro del circuito y evitar que el paciente vuelva a
inspirar el aire exhalado que contiene anestésico. El efecto de cada
uno de estos factores para elevar la concentración de anestésico
inspirado puede corregirse con el uso de alta velocidad de flujo de
entrada de oxígeno (es decir, ≥5 l/min).
Bibliografía
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324 Farmacología y anestesia II
Figura 11-24En el momento cero se cambió el gas inspirado de oxígeno 21%/
óxido nitroso 79% a oxígeno 21%/nitrógeno 79%. El oxígeno arterial descendió en
relación con la emanación de óxido nitroso. (Modificada de Sheffer L, Steffenson
JL, Birch AA: Nitrous-oxide-induced diffusion hypoxia in patients breathing
spontaneously. Anesthesiology 37:436-439, 1972.)