The insufflation and draw-over systems have several disadvantages: poor control of inspired gas con-centration (and, therefore, poor control of depth of anesthesia), mechanical drawbacks during head and neck surgery, and pollution of the operating room with large volumes of waste gas. The Mapleson sys-tems solve some of these problems by incorporat-ing additional components (breathing tubes, fresh gas inlets, adjustable pressure-limiting [APL] valves, and reservoir bags) into the breathing circuit. The relative location of these components determines circuit performance and is the basis of the Mapleson classification ( Table 3–2).
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