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Open Drop Anesthesia

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-continued use in developing countries although not used in modern medicine
-high volatile anesthetic dripped onto a gauze covered mask which is applied to the patient's face
-during inspiration: air passes through the gauze and vaporizes the liquid anesthetic into high concentrations of gas to the patient
-decreased minute ventilation occurs with deep anesthesia which increases the vapor pressure of the anesthetic agent
-increased anesthetic vapor pressure with decreased MV will further lead to deepening anesthesia which can lead to a fatal viscous cycle
-significant rebreathing of anesthetic gases is possible if trapped CO2 is present under the mask
-hypoxic mixtures may be occur if anesthetic agents dilute the inspired oxygen concentration
-to avoid hypoxic mixtures supplemental oxygen may be provided
-uncontrollable pollution of anesthetic gases to the operating room may be hazardous especially with flammable agents

Disadvantages of Insufflation and open drop anesthesia

-poor control of inspired gas concentrations
-inability to assist or control ventilation
-no conservation of heat or humidity
-difficult airway management especially during head and neck procedures
-pollution of large volumes of waste gas into the operating room