Misuse of anaesthetic gases

Sellers, W. F. S.

doi:10.1111/anae.13551

Cited by 6 publications

(7 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Falls in oxygen levels because of high inhaled gas percentage displacing oxygen may have implications of hypoxia for recreational users of asthma inhalers, who are known as “huffers”. Purloined asthma inhalers, when actuated into balloons, empty plastic drink bottles, or other vessels, give a “high” to the person inhaling, and the inhaled gas will have a low oxygen content [14, 15]. In CFC propellant metered dose inhalers it was thought that salbutamol rather than the propellant caused a “high”, because there were no cases of cortico steroid inhaler abuse [16, 17]; an additional anaesthetic or stupifiant effect is likely with current HFA134a pMDIs.…”

Section: Discussionmentioning

confidence: 99%

Asthma pressurised metered dose inhaler performance: propellant effect studies in delivery systems

Sellers¹

2017

Allergy Asthma Clin Immunol

View full text Add to dashboard Cite

Background: Current pressurised metered dose asthma inhaler (pMDI) propellants are not inert pharmacologically as were previous chlorofluorocarbons, have smooth muscle relaxant‚ partial pressure effects in the lungs and inhaled hydrofluoroalkane 134a (norflurane) has anaesthetic effects. Volumes of propellant gas per actuation have never been measured. Methods:In-vitro studies measured gas volumes produced by pMDIs on air oxygen (O 2 ) levels in valved holding chambers (VHC) and the falls in O 2 % following actuation into lung ventilator delivery devices.Results: Volumes of propellant gas hydrofluoroalkane (HFA) 134a and 227ea and redundant chlorofluorocarbons (CFC) varied from 7 ml per actuation from a small salbutamol HFA inhaler to 16 ml from the larger. Similar-sized CFC pMDI volumes were 15.6 and 20.4 ml. Each HFA salbutamol inhaler has 220 full volume discharges; total volume of gas from a small 134a pMDI was 1640 ml, and large 3885 ml. Sensing the presence of liquid propellant by shaking was felt at the 220th discharge in both large and small inhalers. Because of a partial pressure effect, VHC O 2 % in air was reduced to 11% in the smallest 127 ml volume VHC following 10 actuations of a large 134a salbutamol inhaler. The four ventilator delivery devices studied lowered 100% oxygen levels to a range of 93 to 81% after five actuations, depending on the device and type of pMDI used. Conclusion:Pressurised inhaler propellants require further study to assess smooth muscle relaxing properties.

show abstract

Section: Discussionmentioning

confidence: 99%

Asthma pressurised metered dose inhaler performance: propellant effect studies in delivery systems

Sellers¹

2017

Allergy Asthma Clin Immunol

View full text Add to dashboard Cite

show abstract

“…The canister with 950 psi pressure has a significantly higher potential for barotrauma than the whipped cream dispensers (30 psi) that are commonly used by inhalant users. 4 Additionally, the sulfur dioxide additive in automotive N 2 O might have contributed to the upper airway edema and introduced the risk of bronchoconstriction. 2 Therefore, after securing the airway and stabilizing the patient, determining the source of the inhalation injury is important to anticipating complications.…”

Section: Discussionmentioning

confidence: 99%

“…There is a high rate of abuse among teenagers trying to experience the euphoric effects. 4,6 Obtaining a full social and psychiatric history is crucial to the diagnosis of substance abuse and corresponding risk factors, as well as psychiatric disease and suicidal ideations. Early psychiatric evaluation and intervention are necessary for safe disposition of the patient.…”

Section: Discussionmentioning

confidence: 99%

Upper Aerodigestive Tract Frostbite from Inhalation of Automotive Nitrous Oxide

2018

View full text Add to dashboard Cite

Nitrous oxide, a cryogenic gas, may be abused as an inhalant for its euphoric properties. If inhaled, nitrous oxide may cause frostbite to the oral cavity and upper aerodigestive tract, with possible airway compromise due to edema. In this article we describe what is, to the best of our knowledge, the first case of intentional inhalation of nitrous oxide from an automotive nitrous oxide canister and discuss the management and mechanism of the patient's injury.

show abstract

“…Self-report and departmental surveys of ACPs have indicated that, in addition to alcohol (mostly abused by older anesthesiologists), 3 commonly abused anesthetic agents include not only benzodiazepines, opiates, 4,5 propofol, 6 and ketamine 7 but also inhalational agents. [8][9][10] In comparison to healthcare providers from other specialties who are suffering from chemical dependence, ACPs are more likely to abuse drugs than alcohol and to use drugs intravenously. 11 In 2005, Collins's survey of United States (US) anesthesiology residency programs found that 80% had some experience with impaired residents.…”

Section: Current Prevalencementioning

confidence: 99%

“…Les auto-évaluations et sondages départementaux réalisés auprès du personnel d'anesthésie indiquent que, outre l'alcool (la substance d'abus de choix des anesthésiologistes plus âgés), 3 les agents anesthésiques fréquemment abusés comprennent non seulement les benzodiazépines, les opiacés, 4,5 le propofol 6 et la kétamine, 7 mais également les agents volatils. [8][9][10] Par rapport à d'autres spécialités, le personnel d'anesthésie court un risque plus élevé d'abuser de médicaments que d'alcool, et de consommer des médicaments par voie intraveineuse. 11 En 2005, le sondage de Collins sur les programmes de résidence en anesthésiologie aux É tats-Unis a révélé que 80 % des programmes avaient déjà eu affaire à des résidents sous l'emprise de drogues.…”

Section: Prévalence Actuelleunclassified