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Ceasing routine use of nitrous oxide-a follow up
M Enlund1, L Edmark, B Revenäs
1Department of Anaesthesia and Intensive Care, Central Hospital, SE-721 89 Västerås, Sweden. mats.enlund@ltvastmanland.se
British Journal of Anaesthesia
|April 17, 2003
Summary
The routine use of nitrous oxide in anesthesia was discontinued, with most staff finding its benefits minimal. Anesthesia drug use remained stable, with a slight increase in hypnotics, suggesting its value may be overestimated.
Area of Science:
- Anesthesiology
- Pharmacology
Background:
- The utility of nitrous oxide in contemporary anesthesia practice is under scrutiny.
- Routine administration of nitrous oxide was ceased in a hospital department starting November 1, 2000.
Purpose of the Study:
- To evaluate the consequences of discontinuing routine nitrous oxide use in anesthesia.
- To assess staff perceptions and changes in hypnotic and opioid utilization post-cessation.
Main Methods:
- A staff questionnaire was administered after six months.
- Drug utilization (hypnotics and opioids) was analyzed over twelve months.
- Drug costs were compared for the year following discontinuation versus two years prior.
Main Results:
- Less than 50% of 55 staff members used nitrous oxide post-discontinuation, and infrequently.
- Half of the staff perceived nitrous oxide's benefits as minor, with majority support for the policy change.
- Opioid usage remained consistent; hypnotic use increased by 12-14% annually over three years.
Conclusions:
- Staff strongly accepted the policy change, with no significant increase in other anesthetic agents.
- The study questions the previously overestimated value of nitrous oxide in anesthesia.