Influence of Nitrous Oxide on Minimum Alveolar Concentration of Sevoflurane for Laryngeal Mask Insertion in Children

Kihara, Shinichi; Yaguchi, Yuichi; Inomata, Shinichi; Watanabe, Seiji; Brimacombe, J.; Taguchi, Noriko; Komatsuzaki, Tetsuya

doi:10.1097/00000542-200311000-00008

Cited by 38 publications

(26 citation statements)

References 11 publications

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“…6 Also, when incorporated into the gas mixture administered to a patient, N 2 O reduces the necessary minimum alveolar concentration of other concomitantly used anesthetic gases (ie, isoflurane, desflurane, or sevoflurane). 7 Consequently, a smaller amount of a volatile anesthetic agent is required to achieve the same level of anesthesia when N 2 O is added than when the volatile agent is used alone. Moreover, because N 2 O is eliminated from the body so quickly at the termination of the anesthetic, the reduced amount of volatile agent remaining also contributes to a more prompt recovery from general anesthesia, and adverse effects of the lower amounts of these potent anesthetic agents are decreased.…”

Section: Nitrous Oxidementioning

confidence: 99%

Environmental Implications of Anesthetic Gases

Yasny

White²

2012

Anesthesia Progress

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For several decades, anesthetic gases have greatly enhanced the comfort and outcome for patients during surgery. The benefits of these agents have heavily outweighed the risks. In recent years, the attention towards their overall contribution to global climate change and the environment has increased. Anesthesia providers have a responsibility to minimize unnecessary atmospheric pollution by utilizing techniques that can lessen any adverse effects of these gases on the environment. Moreover, health care facilities that use anesthetic gases are accountable for ensuring that all anesthesia equipment, including the scavenging system, is effective and routinely maintained. Implementing preventive practices and simple strategies can promote the safest and most healthy environment.

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Section: Nitrous Oxidementioning

confidence: 99%

Environmental Implications of Anesthetic Gases

Yasny

White²

2012

Anesthesia Progress

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“…17 The patients in our study received midazolam as premedication and propofol as induction agent. In some studies, no premedication was allowed, 7,11,24 while in others, intravenous induction agents were avoided and anaesthesia was induced using a volatile anaesthetic and/or N 2 O. 2,5,10 Although GABA A agonists, such as midazolam, may decrease the analgesic effect of N 2 O, a small dose (7.5 mg) was administered two hours preoperatively in our study.…”

Section: Resultsmentioning

confidence: 93%

Entropy of the electroencephalogram as applied in the M-Entropy S/5™ Module (GE Healthcare) during increases in nitrous oxide and constant sevoflurane concentrations

Smith

Spijkerman

Becker

et al. 2010

Southern African Journal of Anaesthesia and Analgesia

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Background: It has been suggested that spectral entropy of the electroencephalogram as applied in the M-Entropy S/5 TM Module (GE Healthcare) does not detect the effects of nitrous oxide (N 2 O). The aim of this study was to investigate the effect on entropy by graded increases in N 2 O concentrations in the presence of a constant concentration of sevo urane, in the absence of surgical stimulation. Method: This single-blind, randomised study was conducted at an altitude of approximately 1 400 m. Patients received sevo urane 2% (1.7% at sea level) and N 2 O, at end-tidal concentrations of 0%, 10%, 20%, 30%, 40%, 50%, 60% or 70% (equivalent to 8.5%, 17%, 25.5%, 34%, 42.6%, 51.1% and 59.6% at sea level). Entropy was measured before, during and after N 2 O administration. The absolute changes and ratios o f entropy relative to the baseline were calculated. Between-and within-group comparisons were made using analysis of variance and covariance. Results: None of the entropy variables differed signi cantly within and between groups before and after N 2 O administration. Within-group analysis revealed that entropy during N 2 O administration was signi cantly lower than before or after N 2 O administration (P < 0.007). While a minor clinical but statistically signi cant linear relationship was observed between increasing N 2 O concentration and decreasing entropy from N 2 O 0% to 60%, a steeper and clinically important decrease (relative change > 20%) was noted at N 2 O > 60% (> 51% at sea level). Conclusions: The M-Entropy Module S/5TM responds to increasing concentrations of N 2 O in the presence of 2% (1.7% at sea level) sevo urane, in the absence of surgical stimulation. There is a linear relationship between increasing N 2 O concentrations and decreasing entropy with a steep and clinically important decrease at N 2 O > 60% (> 51% at sea level). The in uence of ambient pressure on the partial pressures, which determine the effects of anaesthetic agents, must be taken into account.

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“…Kihara et al [19] reported that 33% and 67% N 2 O reduced the EC 50 of sevofl urane for LMA insertion in children by 22% and 49%, respectively, and that the interaction between N 2 O and sevofl urane was additive. Assuming that the same would hold true in adults, we used 50% N 2 O to further lower the EC 50 of desfl urane for LMA insertion.…”

Section: Discussionmentioning

confidence: 99%

Desflurane requirements for laryngeal mask airway insertion during inhalation induction

et al. 2009

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Influence of Nitrous Oxide on Minimum Alveolar Concentration of Sevoflurane for Laryngeal Mask Insertion in Children

Abstract: Nitrous oxide and sevoflurane suppress the responses to LMA insertion in a linear and additive fashion in children.

Cited by 38 publications

References 11 publications

Environmental Implications of Anesthetic Gases

Environmental Implications of Anesthetic Gases

Entropy of the electroencephalogram as applied in the M-Entropy S/5™ Module (GE Healthcare) during increases in nitrous oxide and constant sevoflurane concentrations

Desflurane requirements for laryngeal mask airway insertion during inhalation induction

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