Fresh gas flow reduction to less than 1 L/min during maintenance phase of general anaesthesia is well associated with several benefits. Aggrandized preservation of temperature and humidity, money saving through better utilization of inhaled anesthetic agents, and environmental issues are three basic reasons to implementation of low or minimal-flow anesthesia.

The benefits and feasibility of low-flow anaesthesia have been already suggested for nearly two decades.²In 1995, Baum and Atikenhead³presented that: ‘‘Although there are potential risks associated with low-flow anesthesia, modern anesthesia machines meet all the technical requirements for the safe use of low-flow techniques if they are used in conjunction with equipment for monitoring inhaled and exhaled gas concentrations; these monitors are already increasingly available and, in the near future, are likely to become an obligatory safety standard in many countries. For both economic and ecological reasons, the use of new inhalational anaesthetics, with low tissue solubility and low anesthetic potency, can be justified only if the efficiency of administration is optimized by using low flow anesthetic techniques.’’

New inhaled anaesthetics, sevoflurane and desflurane, have quite low blood and low tissue solubility, which helps in rapid equilibration between the alveolar and effect site (brain) concentrations and makes them ideally suited for low flow techniques. Modern anaesthesia machines are well designed for low flow anaesthesia techniques, which have leak free circle systems, highly efficient CO₂absorbers, and the common practice of utilizing on line real-time multi-gas monitor, including essential alarm systems and many more advanced features, allow for safe and cost effective low flow techniques during maintenance of anesthesia.

Few of recent studies also showed that respiratory function and also mucociliary clearance are better preserved with a low flow anesthetic technique as compared with high-flow anesthesia. 

There are no absolute contraindications to utilizing low-flow anesthesia during elective general anesthesia. Keeping in mind the long-time constants of low-flow techniques, it may not be optimal to use low-flow techniques in emergency cases or in medically complex patients where a rapid adjustment of the inhaled anesthetic concentration may be required.

Even though low flow anaesthesia concept is very beneficial and quite easy to learn and practice, it is not so popular in day to day clinical practices even at tertiary care hospital and institute in most of developing countries. Theoretical knowledge and practical implications both are necessary to fulfilling the ultimate aim of any clinical concept. In most of teaching and research institute on floor anaesthesiologists are youngsters like junior and senior anaesthesia residets. Their knowledge and day to day practices towards low flow anaesthesia are very important for actual implications of low flow anaesthesia concept. Therefore, we deiced to assessment of knowledge and practice of low flow anaesthesia by randomly observing their practice in low flow anaesthesia first than we also decided to get their responses via questionnaire.

 For assessment of low flow anaesthesia practice at our tertiary care hospital, we will be observe the total fresh gas flow (ltr/min) and dial setting of inhalational agents randomly during maintenance of surgical anaesthesia without the knowledge of the ground users. We will also made the questionnaire for assessing the knowledge and clinical practice of low flow anaesthesia in day to day practice. We decided to get responses from young anaesthesiologists including junior and senior residents of anaesthesia from our tertiary care research institute of India.