Effects of nitrous oxide on haemodynamic and electroencephalographic responses induced by tetanic electrical stimulation during propofol anaesthesia

Inada, Takefumi; Shingu, Koh; Nakao, Shinichi; Nagata, Atsushi

doi:10.1046/j.1365-2044.1999.00752.x

Cited by 10 publications

(11 citation statements)

References 21 publications

(36 reference statements)

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“…This finding corroborates the results of Inada et al (1999), who demonstrated hemodynamic stability associated with the use of N 2 O and propofol. This finding is also consistent with a report by Nishimori et al (2007), who also observed cardiovascular stability using propofol at a dose of 0.4 mg kg -1 min -1 in association with 30% N 2 O.…”

Section: Introductionsupporting

confidence: 91%

Effects of nitrous oxide on cardiovascular parameters in pigs anesthetized with propofol and subjected to pressure-controlled ventilation

Carneiro

Lopes

Gering

et al. 2017

SCA

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This paper evaluated the effects of the ratio of nitrous oxide to oxygen (50% of each) on cardiovascular parameters in pigs anesthetized with propofol and maintained in ventilation with intermittent positive pressure. Sixteen Large White pigs, weighing between 15 and 20 kg, were divided into two groups of eight animals, and designated as follows: GPN (propofol/nitrous oxide) and GPA (propofol/compressed air). In order to allow endotracheal intubation, the animals received azaperone (2 mg kg -1 , IM) followed, after 20 minutes, by intravenous propofol. After successful intubation, continuous infusion of propofol was initiated at a dose of 0.4 mg kg -1 minute -1 . From this point, the GPN group received N 2 O (diluted in 50% oxygen), while the GPA group received compressed air (diluted in 50% oxygen). Rocuronium was then administered by continuous intravenous infusion at 0.6 mg kg -1 h -1 . Pressurecontrolled ventilation (PCV) was started and adjusted to 15 cmH 2 O, and the respiratory rate was set to reach capnometry readings between 35-45 mmHg. The measurement of parameters (heart rate, mean arterial pressure, cardiac index, systemic vascular resistance index, stroke index) begun 15 minutes after the administration of rocuronium, and was repeated in 15-minute intervals for 60 minutes. Data were statistically analyzed by ANOVA followed by Bonferroni test. The results showed that the 1:1 ratio combination of nitrous oxide to oxygen (50% each) did not alter the mentioned parameters in pigs anesthetized with propofol and maintained at pressure-controlled ventilation, indicating that it is a safe protocol for the cardiovascular system.

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Section: Introductionsupporting

confidence: 91%

Effects of nitrous oxide on cardiovascular parameters in pigs anesthetized with propofol and subjected to pressure-controlled ventilation

Carneiro

Lopes

Gering

et al. 2017

SCA

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“…However, we assume that the depth of anaesthesia in both groups can be considered to be clinically similar. We could have monitored the depth of anaesthesia by measuring, for example, the bispectral index (BIS) or spectral edge frequencies from the electroencephalogram (EEG) [27,28]. However, even with such EEG‐derived parameters, it would not be possible to achieve an equal depth of anaesthesia between the groups because propofol and isoflurane have different effects on EEGs and thus the patterns of the EEG during each type of anaesthesia is different [29,30].…”

Section: Discussionmentioning

confidence: 99%

Effect of propofol and isoflurane anaesthesia on the immune response to surgery*

et al. 2004

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SummaryThere are two major subpopulations of peripheral helper T lymphocytes: T helper 1 (Th1) and T helper 2 (Th2) cells. Surgical stress increases the number of Th2 cells, and decreases that of Th1 cells, resulting in a decrease in the Th1 ⁄ Th2 ratio, and, consequently, in suppressed cellmediated immunity. Since anaesthesia can suppress the stress response to surgery, it may inhibit the decrease in the Th1 ⁄ Th2 ratio. Using flow cytometry, we studied whether propofol anaesthesia (n = 9) or isoflurane anaesthesia (n = 9) had more effect on the decrease in the Th1 ⁄ Th2 ratio after surgery in patients undergoing craniotomy. The Th1 ⁄ Th2 ratio decreased significantly after isoflurane anaesthesia (p = 0.011), while it did not change after propofol anaesthesia. The ratio was significantly lower with isoflurane than propofol (p = 0.009). Propofol anaesthesia attenuated the surgical stress-induced adverse immune response better than isoflurane anaesthesia.

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“…Of these, we selected 225 for full‐text review, of which 188 papers were excluded because they did not meet our eligibility criteria. After this process we identified a further 15 papers, reporting on 12 studies , which also required exclusion for not meeting these criteria. Of these 12 studies, six did not include an intervention or comparator relevant to this review , in five studies the depth of anaesthesia differed between study arms [ and two papers reported on the ENIGMA‐2 study , which did not measure AAGA.…”

Section: Resultsmentioning

confidence: 99%

Nitrous oxide‐based vs. nitrous oxide‐free general anaesthesia and accidental awareness in surgical patients: an abridged Cochrane systematic review

et al. 2017

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Summary Accidental awareness during general anaesthesia can arise from a failure to deliver sufficient anaesthetic agent, or from a patient's resistance to an expected sufficient dose of such an agent. Awareness is ‘explicit’ if the patient is subsequently able to recall the event. We conducted a systematic review into the effect of nitrous oxide used as part of a general anaesthetic on the risk of accidental awareness in people over the age of five years undergoing general anaesthesia for surgery. We included 15 randomised controlled trials, 14 of which, representing a total of 3439 participants, were included in our primary analysis of the frequency of accidental awareness events. The awareness incidence rate was rare within these studies, and all were considered underpowered with respect to this outcome. The risk of bias across all studies was judged to be high, and 76% of studies failed adequately to conceal participant allocation. We considered the available evidence to be of very poor quality. There were a total of three accidental awareness events reported in two studies, one of which reported that the awareness was the result of a kink in a propofol intravenous line. There were insufficient data to conduct a meta‐ or sub‐group analysis and there was insufficient evidence to draw outcome‐related conclusions. We can, however, recommend that future studies focus on potentially high‐risk groups such as obstetric or cardiac surgery patients, or those receiving neuromuscular blocking drugs or total intravenous anaesthesia.

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Effects of nitrous oxide on haemodynamic and electroencephalographic responses induced by tetanic electrical stimulation during propofol anaesthesia

Cited by 10 publications

References 21 publications

Effects of nitrous oxide on cardiovascular parameters in pigs anesthetized with propofol and subjected to pressure-controlled ventilation

Effects of nitrous oxide on cardiovascular parameters in pigs anesthetized with propofol and subjected to pressure-controlled ventilation

Effect of propofol and isoflurane anaesthesia on the immune response to surgery*

Nitrous oxide‐based vs. nitrous oxide‐free general anaesthesia and accidental awareness in surgical patients: an abridged Cochrane systematic review

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