Anaesthesia at remote location: use of modified Bain circuit (Mapleson D) at Kunri Christian Hospital (KCH).

OBJECTIVE To develop a safe general anaesthesia technique for remote areas with lack of facilities. METHODS Four types of anaesthesia techniques using TIVA and modified Bain circuit were planned. Monitoring facility was limited to manual sphygmomanometer, palpation of radial pulse and monitoring of colour of skin and blood. Depth of anaesthesia was assessed using EVANs, RPST scoring system. Patients were asked in recovery room for awareness. RESULTS Surgeries done were cesarean sections, laparotomies, gynaecological, urological, hernia and burn contractures. Six patients had RPST score of 5 or more and three patients in recovery room complained of awareness. Cost per Anaesthesia was Rs225. CONCLUSION TIVA with modified Bain circuit provided effective anaesthesia in remote area at low cost.