Physical Characteristics of and Rates of Nitrous Oxide Diffusion into Tracheal Tube Cuffs

Bernhard, W; Yost, Leon; Turndorf, Herman; Cottrell, James E.; Paegle, Roland D.

doi:10.1097/00132586-197904000-00009

Cited by 11 publications

(13 citation statements)

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“…Nitrous oxide is known to partition into gas filled spaces and can increase the volume/pressure in the endotracheal cuff if it is inflated with only air before nitrous oxide usage (Bernhard and others 1978, Nguyen and others 1999). However, nitrous oxide was not used in this case during the general anaesthetic before the problem.…”

Section: Discussionmentioning

confidence: 99%

Tracheal necrosis following tracheal intubation in a dog

Alderson

Senior

Dugdale

2006

J of Small Animal Practice

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Section: Discussionmentioning

confidence: 99%

Tracheal necrosis following tracheal intubation in a dog

Alderson

Senior

Dugdale

2006

J of Small Animal Practice

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“…[5] Cuff pressure greater than 30 cm H 2 O, the use of nitrous oxide, and the lack of frequent Adjustment of cuff pressure is thought to be the most important factor that contributes to postoperative airway complications even in minor procedures. [67]…”

Section: Introductionmentioning

confidence: 99%

Low flow anesthesia: Efficacy and outcome of laryngeal mask airway versus pressure-optimized cuffed-endotracheal tube

et al. 2010

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BackgroundLow flow anesthesia can lead to reduction of anesthetic gas and vapor consumption. Laryngeal mask airway (LMA) has proved to be an effective and safe airway device. The aim of this study is to assess the feasibility of laryngeal mask airway during controlled ventilation using low fresh gas flow (1.0 L/min) as compared to endotracheal tube (ETT).Patients and MethodsFifty nine non-smoking adult patients; ASA I or II, being scheduled for elective surgical procedures, with an expected duration of anesthesia 60 minutes or more, were randomly allocated into two groups - Group I (29 patients) had been ventilated using LMA size 4 for females and 5 for males respectively; and Group II (30 patients) were intubated using ETT. After 10 minutes of high fresh gas flow, the flow was reduced to 1 L/min. Patients were monitored for airway leakage, end-tidal CO2(ETCO2), inspiratory and expiratory isoflurane and nitrous oxide fraction concentrations, and postoperative airway-related complications.ResultsTwo patients in the LMA-group developed initial airway leakage (6.9%) versus no patient in ETT-group. Cough and sore throat were significantly higher in ETT patients. There were no evidences of differences between both groups regarding ETCO2, uptake of gases, nor difficulty in swallowing.Conclusion:The laryngeal mask airway proved to be effective and safe in establishing an airtight seal during controlled ventilation under low fresh gas flow of 1 L/min, inducing less coughing and sore throat during the immediate postoperative period than did the ETT, with continuous measurement and readjustment of the tube cuff pressure.

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“…Nitrous oxide and other gases diffuse into air filled cuffs of tracheal tubes and supraglottic devices, increasing their volume and pressure. [11–13] The addition of plasticizers to the polyvinyl chloride cuff material of the tracheal tubes and disposable LMAs softens it and renders it less permeable to nitrous oxide. [1415]…”

Section: Discussionmentioning

confidence: 99%

ProSeal ^TM laryngeal mask airway cuff pressure changes with and without use of nitrous oxide during laparoscopic surgery

Sharma

Sehgal

Koul

et al. 2013

J Anaesthesiol Clin Pharmacol

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Background:The ProSeal™ laryngeal mask (PLMA) is increasingly being used as an airway device for laparoscopic surgery. Its silicone cuff allows diffusion of nitrous oxide, carbon dioxide and other gases with resultant rise in its intracuff pressure during anesthesia. The present study was designed to investigate the intracuff pressure changes during anesthesia with and without nitrous oxide in patients undergoing laparoscopic surgery lasting up to two hours.Materials and Methods:One hundred patients, American Society of Anesthesiologists physical status 2 and 3, undergoing general anesthesia with muscle paralysis, were randomized into two groups of 50 patients each to receive an anesthetic gas mixture containing either oxygen and nitrous oxide (group N) or oxygen and air (group A). Following insertion of an appropriate size PLMA, its cuff was inflated with air to an intracuff pressure of 45 mm Hg. The cuff pressure was measured every 10 minutes for the entire course of anesthesia. The position of the device was also assessed fiberoptically and postoperative airway complications were recorded.Results:The maximum intracuff pressure recorded in group N was 103 ± 4.7 mm Hg vs. 45.5 ± 1.5 mm Hg in group A. The percentage rise in cuff pressure every 10 minutes was also highly significant (P < 0.001) being maximum in first 10 min in group N. The incidence of postoperative airway complications was comparable between the two groups.Conclusion:The results of this study demonstrate that the intracuff pressure of the PLMA increases progressively over time when the breathing gas mixture contains nitrous oxide.

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Physical Characteristics of and Rates of Nitrous Oxide Diffusion into Tracheal Tube Cuffs

Cited by 11 publications

References 0 publications

Tracheal necrosis following tracheal intubation in a dog

Tracheal necrosis following tracheal intubation in a dog

Low flow anesthesia: Efficacy and outcome of laryngeal mask airway versus pressure-optimized cuffed-endotracheal tube

ProSeal ^TM laryngeal mask airway cuff pressure changes with and without use of nitrous oxide during laparoscopic surgery

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Physical Characteristics of and Rates of Nitrous Oxide Diffusion into Tracheal Tube Cuffs

Cited by 11 publications

References 0 publications

Tracheal necrosis following tracheal intubation in a dog

Tracheal necrosis following tracheal intubation in a dog

Low flow anesthesia: Efficacy and outcome of laryngeal mask airway versus pressure-optimized cuffed-endotracheal tube

ProSeal TM laryngeal mask airway cuff pressure changes with and without use of nitrous oxide during laparoscopic surgery

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Product

Resources

About

ProSeal ^TM laryngeal mask airway cuff pressure changes with and without use of nitrous oxide during laparoscopic surgery