Anesthesia Machine

Dr Umesh G
Associate Professor
Department of Anaesthesiology
KMC, Manipal
 Components
• Source of supply
• Yoke assembly
• Pressure gauge
• Pressure regulators
• Oxygen pressure failure safety / warning devices
• Flow meters
• Oxygen ratio control devices
• Vaporisers
• Common gas outlet
• Breathing systems
 Source of supply
• Central supply – Oxygen, Nitrous oxide,
Vacuum
– Quick couplers
– Diameter index safety systems
• Cylinder – Oxygen, Nitrous oxide,
air
– Pin index
Yoke assembly
• Body
• Retaining screw
• Index pins
• Gas seal
• Filter
• Check valve
assembly
Pin index
Pressure gauge
• Bourdon type
Pressure regulators
• Convert high variable pressure
from cylinder to a constant
working pressure
• Frequent adjustments not needed
• Fine adjustment of flow possible
• Less chance of bursting of tube
and blowing up of connections
Pressure regulators
 Functioning principle – Pressure
regulators

A large pressure acting over a small area is balanced

by a smaller pressure acting over a large area. The
relative sizes of the arrows represent the magnitudes
of the pressures
 High pressure system

• Cylinder,
• Hanger yoke assembly (including pin indices)
• Pressure gauge
• Pressure regulators
 Intermediate pressure system
• Pipeline
• Its connections (quick couplers, diameter
index safety systems)
• Pressure gauge
• Oxygen failure safety devices
• Oxygen flush
• Second stage pressure regulators
Oxygen pressure failure safety /
warning devices

• Alarm to failing O2 supply

• Cut off further N2O supply

• Slave regulators
Oxygen failure safety valve
Oxygen flush
Low pressure system - Flow meters

• Measure the flow of

gas – Thorpe tube
• Float / Bobbin
• Flow control knob
• Variable orifice type
• High flows – Density dependent,
Graham’s law
• Low flows – Viscosity dependent,
Poisseulle’s law
 Oxygen ratio control device
Link 25
•
 Oxygen ratio monitoring control device

No 32
Video clip
Scan 182 Miller

ORMC
Vaporisers
Breathing systems
They are the technical
elements of anaesthetic
machines by means of
which anaesthetic gas is
administered to the patient
REQUIREMENTS OF A BREATHING
SYSTEM:

Essential:
The breathing system must
a) deliver the same concentration of gases to
the alveoli as set in the shortest possible time
b) effectively eliminate carbon-dioxide
c) have minimal apparatus dead space
d) have low resistance
 REQUIREMENTS OF A
BREATHING SYSTEM:
Desirable:
The desirable requirements are
a) economy of fresh gas
b) conservation of heat
c) adequate humidification of inspired gas
d) light weight
e) convenience during use
 REQUIREMENTS OF A
BREATHING SYSTEM:

f) efficiency during spontaneous as well as

controlled ventilation (in terms of CO2
elimination and fresh gas utilisation)
g) adaptability for adults, children and
mechanical ventilators
h) provision to reduce theatre pollution
Unidirectional flow
Apparatus dead space
 Types of Circuits
• Mapleson systems

• Basic circle system

 Components of Mapleson
systems
• Reservoir bag
• Airway pressure relief valve
• Fresh gas flow
• Patient end
• Breathing conduit
 Mapleson
systems

Fresh gas flows ≥

minute volume
 Mapleson A
• FGI near bag
• Breathing tubing
• Expiratory valve near mask
• Volume of breathing tube should be as
great as the tidal volume
• Spontaneous ventilation
• High FGF flushes tubing between breaths
 Mapleson B
• Similar to A with FGI near expiratory valve
• System fills with FGF
• Exhaled gas forced out through expiratory
valve
 Mapleson C
• Similar to Mapleson B
• Shorter breathing tubing
– less dead space
 Mapleson D
• Long breathing tube
• FGI near mask
• Exhalation valve at distal end of breathing
tubing
 Bain Breathing Circuit
• Modified Mapleson D
• Tube within a tube
– FGF tube within larger tube
• Mounts on anesthesia machine
• APL valve
• Connects to scavenger
 Bain System
• Advantages
– compact, easy to handle
– warming of inspired gases
– partial rebreathing improves humidification
– APL controls system pressure
– ability of scavenging
 Mapleson E
• Exhalation tube is reservoir
– no bag
• FGI near mask
• Current use?
 Mapleson F
• FGI near mask
• Breathing tubing/bag
• Expiratory valve at end of bag
• Current use?
 Airway pressure
Unidirectional valves relief valve

Reservoir
bag

CO2
Inspiratory & absorbent
Fresh Gas
Expiratory limbs Flow
Essential components
(Circle system)
 Circle System
• Allows rebreathing of anaesthetic gases
– lower FGF rates
– Less pollution
• Requires CO2 absorption
• Conserves heat and humidity
 Advantages of Circle System
• Highly efficient
• Minimal dead space
• Conserves heat and moisture
• Minimal pollution
• Disadvantage - many places to leak
 CO2 Absorption
• Soda lime
– 94% calcium hydroxide
– 5% sodium hydroxide
– 1% potassium hydroxide
– silica to harden granules
– ethyl violet as an indicator
 CO2 Absorption
• Baralime
– 80% calcium hydroxide
– 20% barium hydroxide
– ethyl violet as an indicator
 CO2 Absorption
• pH is extremely high
• Granule size
– 4 8 mesh
• Water is required for chemical reactions to
occur