Objective: Low flow anesthesia (LFA) provides a saving up to 75% and improves the dynamics of inhaled anesthesia gas. LFA has been recommended for anesthesiologists in recent years to avoid high fresh gas flow (FGF), however, LFA and minimal flow anesthesia (MFA) use have been limited due to associated risks. The main purpose of this study was to investigate whether LFA and MFA, are feasible and safe. The second aim is to determine the amount of anesthetic agent consumed when these methods are used.

Material and Method: Forty hepatectomy cases in two groups were included to the prospective and observational study. For the 20 cases, 300 mL/min (groupM) FGF was applied; for the 20 cases, 600 mL/min (groupD) was applied. Desflurane (Suprane©) was used as an inhalation agent. Patients’ demographic, respiratory, hemodynamic, and tissue perfusion parameters (SpO2 and NIRS), and comsumption data of anesthetic agent (AA) were collected and compared.

Results: No significant differences were detected between the groups in terms of demographic data, duration of surgery, and hemodynamic, respiratory, and tissue perfusion parameters. The maximum O2 concentration in the FGF that maintained FiO2=0.4 and provided adequate oxygenation during the LFA/Minimal Flow Anesthesia (MFA) was 61% in groupD, and 89% in groupM (p <0.001). The hourly AA consumption was 34% lower in groupM (10.50 ± 3 mL) than in groupD (14.10 ± 4 mL/h).

Conclusion: We performed 300 mL/min FGF speed without deviating from the safety limits in hepatectomies, reducing the anesthetic agent costs ≈ approximately to 34% compared with 600 mL/min FGF.