0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
ARTICLE |

The Quantitative Practice of Anesthesia: Use of Closed Circuit

Ronald M. Meyer, MD
JAMA. 1981;246(23):2748-2749. doi:10.1001/jama.1981.03320230064035.
Text Size: A A A
Published online

ABSTRACT

A large proportion of anesthetics in this country are administered using a "semiclosed" gas delivery system. This technique presents an excess of drug to the lungs to achieve easily predictable alveolar (thus arterial, thus cerebral) anesthetic concentrations. It is analogous to running a rapid dopamine infusion with three fourths of the solution leaking out of a poorly connected intravenous tubing before entering the patient. Not only is the semiclosed system wasteful, but the absence of knowledge of total dose of drug given makes informed analysis of the response difficult. The act of sealing the anesthetic system (closing the circuit) has many advantages, the greatest being the skill and comprehension required to maintain safe anesthesia under this condition.

The authors of this book derive rules for closed-circuit anesthesia from basic physiology and pharmacology. Physical-chemical properties of anesthetics acquire new relevance. The authors emphasize practicality. Although they use differential calculus to present

Topics

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Figures

Tables

References

Letters

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();