The "Second Gas Effect" Is Not a Valid Concept

Sun, Xing-Guo; Shi, Y.; Lee, Chingmuh

doi:10.1097/00000539-199901000-00035

Cited by 7 publications

(7 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Some perceived benefits may be overstated. For example, nitrous oxide is purported to speed induction of anaesthesia via the second gas effect but this has not been consistently borne out by clinical studies [13].…”

Section: Discussionmentioning

confidence: 99%

The use of nitrous oxide in paediatric anaesthetic practice in the United Kingdom: a questionnaire survey*

Sheraton

Gildersleve²,

Hall

2006

Anaesthesia

View full text Add to dashboard Cite

SummaryNitrous oxide pollution is common in paediatric anaesthetic practice. A questionnaire was sent to all UK members of the Association of Paediatric Anaesthetists requesting details of three areas of their paediatric practice relating to nitrous oxide: attitudes to its use; current usage; and availability of alternatives. Replies were received from 296 (68%) consultants. Of these, 169 (57%) stated that their use of nitrous oxide had decreased over the last 5 years. One hundred and fifty-eight (54%) considered theatre pollution a problem in paediatric anaesthesia. One hundred and sixty-nine (57%) reported that in normal circumstances potential deleterious effects on patients influenced their use of nitrous oxide, whilst only 70 (24%) felt potential effects on staff influenced usage. Fifty-five (18%) felt there should be some restriction in the availability of nitrous oxide.

show abstract

Section: Discussionmentioning

confidence: 99%

The use of nitrous oxide in paediatric anaesthetic practice in the United Kingdom: a questionnaire survey*

Sheraton

Gildersleve²,

Hall

2006

Anaesthesia

View full text Add to dashboard Cite

show abstract

“…Recently, Sun et al 9 reported that the second gas effect was not a valid concept. Although there are some experimental design differences between our study and theirs, our results do not support their suggestion.…”

Section: Resultsmentioning

confidence: 99%

Second gas effect of N2O on oxygen uptake

Nishikawa

Kunimoto

Isa

et al. 2000

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

“…The second gas effect was proposed by Epstein et al (1) and was proven in the consecutive study (13). However, in the study carried out by Sun et al (14), it was determined that the F A /F i ratio and arterial blood concentration did not show any difference with the addition of N 2 O to enflurane in the first five minutes; they claimed that the second gas effect is not a clinically valid concept. When Mutoh et al (15) compared the dog groups in which N 2 O was added and was not added to sevoflurane and isoflurane, they determined that N 2 O had not improved the quality of mask induction and that the concentration and second gas effects had been minimal.…”

Section: Discussionmentioning

confidence: 97%

“…In the study of Sun et al (14) in which they did not accept the second gas effect, the ventilation parameters were not kept constant, and the cardiac effects of N 2 O were ignored. The effects of N 2 O on the functions of the cardiovascular system are increasing the HR and arterial blood pressure mildly, and thus the cardiac output, by stimulating the sympathetic nervous system.…”

Section: Discussionmentioning

confidence: 99%

“…This effect becomes even more pronounced at higher concentrations (12). Sun et al (14) used N 2 O at high concentrations in their experimental group. Taheri and Eger (16), criticizing this study, stated that to prevent ventilatory differences and to keep the respiratory quotient (RQ) constant, the ventilation parameters should be adjusted so as to keep the ETCO 2 concentration constant in the study groups.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Nitrous Oxide Effects the Uptake of Sevoflurane to the Body During Induction

Erel¹,

Gürsoy²,

Kurt³

et al. 2018

meandros

View full text Add to dashboard Cite

ÖzAmaç: İnhalasyon indüksiyonu sırasında azot protoksit gazının (N 2 O) sevofluranın vücuda alınması sürecinin hızı ve kalitesi üzerindeki etkilerini araştırmaktır. Gereç ve Yöntemler: Jinekolojik müdahale yapılması planlanan Amerikan Anestezistler Derneği kriterlerine göre I-II grubunda 84 kadın hasta randomize edilerek iki gruba ayrıldı. Tek soluk indüksiyonu yöntemi ile anestetize edilen hastalarda birinci gruba [Grup sevoflurane and azot protoksit (SA)] indüksiyonda %8 sevofluran, %67 azot protoksit ve %33 oksijen, ikinci gruba [Grup sevofluran (S) ve azot protoksit] %8 sevofluran ve %100 oksijen uygulandı. İndüksiyon sırasında oksijen, karbondioksit ve sevofluranın end-tidal ve inspiratuvar yoğunlukları, kirpik refleksinin kaybolmasına kadar geçen süre, gözlerin orta hatta gelmesi AbstractObjective: To determine the effects of nitrous oxide (N 2 O) on the speed and quality of the uptake process of sevoflurane during inhalation induction in adult patients. Materials and Methods: For randomized controlled study, eighty-four American Society of Anesthesiologists I-II patients undergoing gynecological interventions were randomly assigned to receive an 8% sevoflurane mixture with either 67% N 2 O plus 33% oxygen [Group sevoflurane and nitrous oxide (SA)] or 100% oxygen only [Group sevoflurane (S)]. Both groups were induced by a single-breath induction. End-tidal and inspiratory concentrations of respiratory and anesthetic gasses were continuously assessed during induction as well as time to loss of eyelash reflex, time to cessation of eye movements, and time to initiation of spontaneous breaths. Patients were intubated by the 5 th minute of induction and their vital signs, bispectral indexes, reflex responses to intubation and additional drug requirements for intubation were also recorded. Results: End-tidal sevoflurane concentrations and the ratio of alveolar to inspiratory sevoflurane concentrations (F A /F i ) of patients in group SA recorded at the 2 nd , the third and the 5 th minute of induction showed statistically significant increases when compared with patients in group S. Time to loss of eyelash reflex and time to cessation of eye movements were found to be decreased in group SA by 25 and 13%, respectively. Patients who presented with a reflex response to intubation in group S exceeded patients in group SA by 38.8% and patients who required additional medication for intubation in group S exceeded patients in group SA by 28.6%. Conclusion: The findings of this study support the view that administration of N 2 O improves the rate and quality of mask induction with sevoflurane. The benefits provided by N 2 O attributable to the concentrating and second gas effects appear during the first few minutes of induction (2 nd , 3 rd , and 4 th minutes) as well as during intubation when sevoflurane is used for mask induction.

show abstract

The "Second Gas Effect" Is Not a Valid Concept

Cited by 7 publications

References 15 publications

The use of nitrous oxide in paediatric anaesthetic practice in the United Kingdom: a questionnaire survey*

The use of nitrous oxide in paediatric anaesthetic practice in the United Kingdom: a questionnaire survey*

Second gas effect of N2O on oxygen uptake

Nitrous Oxide Effects the Uptake of Sevoflurane to the Body During Induction

Contact Info

Product

Resources

About