Thinking of Buying: Anesthesia Machines


The latest models offer high performance in compact designs.

Five or 10 years ago, a basic anesthesia machine was perfectly suitable in many outpatient ORs. Times have changed, however, as the differences between hospitals and surgery centers continue to narrow. Surgery centers are now caring for larger, older and sicker patients, and performing more complex surgeries such as total joints. This wider pool of patients can present significant anesthetic challenges compared with the younger, healthier individuals who once were the prototypical outpatient surgery patient. Patients who present for surgery with more comorbidities require more finesse in their anesthetic care. As a result, anesthesia providers working at many outpatient centers now require anesthesia machines that offer more precise, versatile controls and richer functionality.

For anesthesia providers the most basic anesthesia machines at ASCs usually worked just fine. If the machine had a manual ventilation mode, basic oxygen and at least one vaporizer, they were good to go. That’s no longer the case. Sleek new platforms designed for fast-paced surgery centers boast small footprints and the control providers need to manage more complex surgeries and sicker patients. 

Assessing the following features when shopping the latest options in anesthesia machines will help you find a model ideally suited for your ASC. 

Ventilation modes. Units with multiple ventilation modes allow anesthesia providers to administer safer anesthetic care. These additional modes — which providers didn’t use as much, or ever, before at outpatient centers — not only enable them to deliver safer care, but also make surgery far easier on the patient while increasing efficiency for the center. For example, I prefer to work with machines that can manage two vaporizers so I can administer either desflurane or sevoflurane. Because efficiency is an issue both clinically and financially at centers, I prefer to administer desflurane because it results in faster emergence and less need for oral airways in the PACU. I also want to be able to administer sevoflurane to certain patients such as children, because the pungent smell of desflurane makes it a less than ideal choice during inhalation inductions.

Anesthesia providers work on a continuum at ASCs, flowing with a patient from pre-op to the OR and to the PACU. We might need to be more conservative about how we drop patients off in the PACU than we would be in a hospital setting where there is typically a float provider available for issues such as airway obstruction. Having a desflurane vaporizer available is optimal because patients will wake up much faster, which prevents providers from taking a groggy patient with an oral airway into the PACU. 

There are several modes of ventilation available on current anesthesia machines that offer varying degrees of functionality: volume-controlled ventilation (VCV); pressure support ventilation (PSV); synchronized intermittent mandatory ventilation (SIMV); pressure-controlled ventilation (PCV); and pressure control with volume guarantee (PCV-VG). When evaluating anesthesia machines for your surgery center, you want to find the middle ground. To some degree, your choice should be tailored to your specific surgery center. If your facility specializes in GI, your care team will barely use a ventilator, let alone advanced modes. In this setting, VCV and PCV, the most basic modes, would be appropriate. But the patient populations at most of today’s surgery centers will require more than these basic, one-size-fits-all modes. If you’re a multispecialty surgery center performing complex surgeries with inhalational anesthesia, the enhanced modes are especially useful.

Monitoring. Every anesthesia provider needs the basic and accurate monitoring of oxygen concentration, gas concentration and end-tidal CO2. Many anesthesia machines have these modalities built-in, while others require the use of standalone monitors. For example, some machines have a separate gas analyzer attached to the oxygen monitor. Machines with integrated monitoring modalities are more expensive, but are the more user-friendly and clinically efficient option.

EMR integration. As more ASCs transition away from paper charts, newer anesthesia machines are compatible with EMR platforms. EMR integration is an important consideration when upgrading anesthesia machines, monitors or when outfitting a new ASC. When the monitor brand is different from the make of the anesthesia machine, EMR integration can be difficult. Some machines require an adapter (one example is called a capsule) that acts as a data networking intermediary between the machine, the anesthesia monitor and the EMR. If your machine is EMR-capable but you can’t get it to automatically feed data to the EMR, your providers might still need to enter the information manually. This isn’t optimal when there are many solutions that allow for automatic data capture. 

Compact designs. Floor space at surgery centers is valuable real estate, so anesthesia machine manufacturers are offering versatile units with advanced capabilities in smaller footprint. Still, you might need to pull back on some options if there isn’t a lot of room to move around the sterile field. Every anesthesia provider would love a machine with a wraparound workstation and all kinds of drawers and storage options, but you might need to forgo these bells and whistles if space is a major concern in your ORs.

Intuitive controls. I’ve used machines with touchscreen controls that were difficult to navigate and at times unresponsive. I’d repeatedly push on the screen to switch the ventilation mode, but it wouldn’t work. That’s not just a time-wasting annoyance, it can also present a patient safety issue. The good news is that many newer machines have user-friendly touchscreens with great functionality that make operating them a breeze.

The key to purchasing the best anesthesia machine for your surgery center is to involve your anesthesia providers in the purchasing process from the start. Let them trial machines before you buy them, so they can tell you which features would allow them to provide safe and efficient care. OSM


Perseus A500
This machine’s built-in advanced data analytics capabilities make it easier to maximize uptime, operate at peak efficiency and stay in compliance with ever-changing regulations. Its improved breathing system, which can be disassembled and reassembled in a few simple steps, facilitates fast gas concentration changes to help providers manage cases with certainty. A generous, well-lit workspace with large drawers, hooks and various shelving options provides space for documentation and organization of accessories, while integrated cable channels and caster cable deflectors help providers reduce clutter. Its design supports various mounting options for monitors, clinical IT hardware, shelves and poles for IV pumps, while a common user interface between the ventilator display, patient monitoring system and clinical IT components promotes intuitive control. A timer-based, fully automatic self-test prepares the machine for safe use. Its Low Flow Wizard feature guides providers to the lowest possible fresh gas flow to minimize costs, while its heated breathing system reduces condensation during extended cases.

GE Healthcare

Carestation 650
GE Healthcare describes this machine as compact, versatile and affordable. Featuring an integrated design suited to fit into small spaces, it includes a range of tools and technology for diverse patient acuities, including software intelligence that delivers information to inform safer patient care. The machine is described as intuitive for anesthesia providers to use, with both ventilation and patient monitoring controls in one seamless interface. Intelligent lighting highlights active flow controls, while visible reinforcement is provided on the ventilation screen to highlight flow status whenever auxiliary ports are in use. The machine’s ecoFLOW technology provides visual guidance to help identify unnecessarily high fresh gas flow rates. A rotating and tilting display arm supports GE’s Carescape patient monitors to bring critical information and controls together for a unified user experience. An integrated gas module brings essential respiratory parameters directly to the ventilator display and frees up space for additional patient monitoring parameters.


Touted as compact and easy to use, this small machine is suited for busy, crowded ORs, yet still provides advanced features such as high-performance ventilation, precision agent dosing, hypoxia prevention technologies and several accessary mounting options. Its MAC Brain feature visualizes agent concentration to support better dosing and planning of agent delivery. The machine’s O2Guard feature, billed as the world’s only system for active hypoxia prevention, automatically overrules the settings and increases the flow of oxygen should the inspired oxygen level drop below 21%. Its Volume Reflector Indicator provides a visual guide that enables the provider to optimize the rebreathing fraction and save anesthetic agent. Despite its small size, the machine offers a tiltable and rotatable touchscreen, seven feet of multipurpose rails for flexible mounting of monitors, tables and accessories, and arms for convenient placement of suction devices. It also features manual breathing bags, a shelf lit by a dimmable LED lamp that provides easy access to the machine’s USB ports and a large drawer with slots for spare vaporizers and an optional lockable compartment.

Mindray North America

A8 Anesthesia Workstation
Mindray says this machine retains traditional features while introducing disruptive technology and flexible integration to ensure patient safety, sync with provider workflow and increase OR efficiency. Featuring several advanced ventilation modes, its integrated High Flow Nasal Cannula helps clinicians intubate more easily and maintain safe oxygen saturation, especially for patients with poor oxygen saturation such as bariatric, pediatric, critically ill or those with difficult airways. The 360-degree rotatable 18.5-inch capacitive touchscreen is said to feature an intuitive user interface, including an easy-to-read status dashboard for efficient troubleshooting. Its comprehensive system check takes less than four minutes. The machine, which can store up to 10 custom provider profiles, includes protective ventilation toolkits to reduce incidence of postoperative pulmonary complications and gas reduction tools to reduce wasteful administration.

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