Anaesthetists Handbook - MEDICAL EDUCATION at University ...

Sevofluranemust be considered on its clinical indications and merits, ratherthan because sevoflurane is an automatic choice.4. Sevoflurane may not be used with Bain circuits or otherMapleson ‘D’ type circuits.5. Paediatric T-piece circuits, Lack circuits (Mapleson type ‘A’) orcircle absorbers may be used for induction – the fresh gas flowrate should not normally exceed six litres per minute.6. Inhalational induction should be followed immediately by lowflowanaesthesia or preferably switching to another agent suchas isoflurane.7. A circle absorber must be used for maintenance of anaesthesiawith sevoflurane.8. Fresh gas flows must be reduced immediately after induction ofanaesthesia and no later than ten minutes into the case. Themaximum fresh gas flow with sevoflurane maintenance is onelitre per minute.If you use sevoflurane, use it on low flowAnaesthetists Handbook January 2010 173