The economic evaluation of nitrous oxide in sevoflurane anesthesia

Abstract

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.Background: Nitrous oxide (N2O) is much cheaper than recently introduced volatile anesthetics such as sevoflurane and desflurane, and can reduce the consumption of these anesthetics. The use of N2O is under current debate. The purpose of this study was to evaluate economic effect of 50% N2O during sevoflurane anesthesia in Korea. Methods: Seventy patients were randomly allocated to Group A or Group N. Anesthesia induction was performed using propofol, rocuronium, and 3-5% of sevoflurane with air (Group A) or 50% N2O (Group N). Fresh gas flow (FGF) was 6 L/min during induction, and 3 L/min for maintenance. Mean arterial pressure (MAP), heart rate (HR), bispectral index (BIS), and minimum alveolar concentration (MAC) were recorded. The consumption of sevoflurane was measured at every 10 minutes for the first 1 hour. The economic effect was analyzed based on the payment criterion of Korean National Health Insurance Service. Results: MAP, HR, BIS, and MAC showed no differences between the two groups. The sevoflurane consumptions for the first 1 hour were 39.2 ± 6.3 ml in Group A and 29.2 ± 4.9 ml in Group N (P ＜ 0.01); and the N2O consumption was 93.7 ± 1.5 L in Group N. The total costs of inhaled anesthetics were 16,190 (14.8

Nitrous Oxide Influence on Induction of Anaesthesia with Sevoflurane

“…Some studies supported the use, while others failed to find any advantage of using nitrous oxide. 14,15 Hall et al 16 used…”

“…Different studies used different measures to define the induction of anaesthesia endpoint. 15,18 In our study, the endpoint used to describe the induction of anaesthesia was when the arm dropped horizontally. It is consistent with any other measure, such as loss of eyelash reflex or loss of voluntary finger tapping or fall of weight held in hand.…”

Use of Nitrous Oxide to Facilitate Induction for Electroconvulsive Therapy: A Case Report

“…First, the time to induction and emergence of anesthesia would be longer due to its blood-gas partition coefficient of 0.65, which would argue against its use in a relatively short procedure like ECT [ 15 ]. Second, hypotension and arrhythmias are more pronounced with sevoflurane when compared to nitrous oxide [ 17 ].…”

Comparison of the endotracheal tube intracuff pressure with cylindrical and tapered cuffs during nitrous oxide exposure: a randomized single-blinded clinical study

“…Anesthesia was maintained with sevoflurane at 2-3 vol% and a total fresh gas flow of 2 L/min (60% N2O and 40% oxygen). In previous studies [14][15][16], the N2O concentration varied between 50% and 70%; hence the middle value (60%) was chosen for the present study. The patients were ventilated with a tidal volume of 6-8 ml/kg and a respiratory rate of 10-12 breaths/min to maintain an end-tidal CO2 of 30-34 mmHg, and a peak inspiratory pressure of less than 18 cmH2O during general anesthesia.…”