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Nitrous oxide administration using commonly available oxygen therapy devices.

P Joshi1, R Ooi, N Soni

  • 1Magill Department of Anaesthetics, Westminster Hospital, London.

British Journal of Anaesthesia
|June 1, 1992
PubMed
Summary
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Nitrous oxide administration for sedation can achieve therapeutic levels (20-30%) with specific oxygen therapy devices. Several masks and nasal prongs effectively delivered the target nitrous oxide concentration in an analogue lung model.

Area of Science:

  • Anesthesiology and Pain Management
  • Respiratory Therapy
  • Medical Device Engineering

Background:

  • Nitrous oxide is a widely used agent for sedation and analgesia.
  • Optimal therapeutic concentrations of nitrous oxide range from 20% to 30%.
  • Limited data exists on the actual delivered concentrations of nitrous oxide and oxygen to the trachea using various oxygen therapy devices.

Purpose of the Study:

  • To evaluate the end-expired concentrations of nitrous oxide and oxygen delivered by different oxygen therapy devices.
  • To determine which devices can achieve therapeutic nitrous oxide concentrations (20-30%) when using a 1:1 nitrous oxide-oxygen mixture.

Main Methods:

  • An analogue lung model was employed to simulate physiological conditions.
  • Several oxygen therapy devices, including Hudson masks (fixed and variable performance) and MC masks, were tested.

Related Experiment Videos

  • Nasal prongs were also evaluated for their delivery capabilities.

    • Main Results:

    • End-expired nitrous oxide concentrations varied significantly, ranging from 6.5% to 34.3% across tested devices.
    • Therapeutic nitrous oxide concentrations were achieved with the Hudson fixed-performance mask (60% nominal oxygen), the variable performance Hudson mask at 4 L/min, MC masks at 4 and 6 L/min, and nasal prongs at 6 and 8 L/min.
    • All tested devices delivered end-expired oxygen concentrations within a safe range.

    Conclusions:

    • Specific oxygen therapy devices, including certain masks and nasal prongs, can effectively deliver therapeutic concentrations of nitrous oxide.
    • Careful selection of oxygen delivery devices and flow rates is crucial for achieving optimal nitrous oxide levels for sedation and analgesia.
    • Further clinical studies are warranted to confirm these findings in human subjects.