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Closed anesthesia with nitrous oxide

S Li1, Z Wang, B Zeng

  • 1Department of Anesthesiology, Xiehe Hospital, Tongji Medical University, Wuhan.

Journal of Tongji Medical University = Tong Ji Yi Ke Da Xue Xue Bao
|January 1, 1996
PubMed
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This study explored a low-flow nitrous oxide (N2O) and oxygen (O2) anesthesia technique in adult patients. The closed-circuit method proved feasible and safe, avoiding hypoxia and hypercapnia.

Area of Science:

  • Anesthesiology
  • Respiratory Physiology

Background:

  • Maintaining adequate oxygenation and ventilation during anesthesia is critical.
  • Nitrous oxide (N2O) is commonly used in anesthesia, but high flow rates can increase costs and pollution.

Purpose of the Study:

  • To evaluate a low-flow wash-in and closed-circuit maintenance technique using N2O-O2 for anesthesia.
  • To assess the feasibility, safety, and potential economic and environmental benefits of this technique.

Main Methods:

  • Twenty adult patients underwent anesthesia induced with thiopental, fentanyl, and succinylcholine, maintained with isoflurane, N2O-O2, and atracurium.
  • Inspired and end-tidal gas concentrations (O2, N2O, CO2), and SpO2 were monitored throughout.
  • A closed anesthesia circuit was initiated after N2O wash-in, maintaining a constant N2O/O2 ratio of 0.7.

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Main Results:

  • During the wash-in period, inspired N2O concentration (FiN2O) reached 30% at 3.83 min, 40% at 6.22 min, and 50% at 14.13 min.
  • After 30 minutes of closed anesthesia, FiN2O stabilized between 46.8% and 51.9% over 180 minutes.
  • No instances of hypoxia or hypercapnia were observed in any patients.

Conclusions:

  • The low-flow wash-in and closed-circuit maintenance technique with N2O-O2 is a feasible and safe anesthetic method.
  • This approach may offer advantages over high-flow N2O-N2 inhalation, including reduced cost and environmental pollution.
  • The technique effectively maintained oxygen saturation and prevented adverse respiratory events.