Canadian Journal of Anaesthesia

, Volume 37, Issue 6, pp 613–617

Nitrous oxide does not exacerbate pulmonary hypertension or ventricular dysfunction in patients with mitral valvular disease

  • Steven N. Konstadt
  • David L. Reich
  • Daniel M. Thys
Reports of Investigation

Abstract

Using the rapid-response thermistor pulmonary artery catheter and transoesophageal echocardiography, this study examined the effects of 100 per cent oxygen, 70 per cent nitrous oxidel30 per cent oxygen, and 70 per cent nitrogenl30 per cent oxygen on the pulmonary circulation and ventricular function in ten patients with pulmonary hypertension. In comparison with baseline measurements, nitrous oxide administration resulted in small but statistically significant (P < 0.05) changes in mean arterial pressure (76 ± 14 to 67 ± 12), mean pulmonary arterial pressure (37 ± 14 to 33 ± 13 mm Hg), and cardiac output (3.7 ± 1.4 to 3.2 ± 1.1 L· min−1). Seventy per cent nitrogen resulted in no significant changes from baseline. The repeat 100 per cent oxygen measurements were nearly identical to the nitrous oxide measurements. It is concluded that nitrous oxide does not exacerbate pulmonary hypertension or ventricular dysfunction during highdose fentanyl anaesthesia in patients with mitral valvular disease.

Key Words

Anaesthesia: cardiac Anaesthetic Gases: nitrous oxide Complications: hypertension, pulmonary Heart: cardiac output, ventricles, function 

Résumé

Utilisant un cathéter d’artère pulmonaire thermistor à réponse rapide et l’échographie transoesophagienne, cette étude examine les effets de 100 pour cent d’oxygéne, 70 pour cent de protoxyde d’azotel30 pour cent d’oxygène, et 70 pour cent d’airl30 pour cent d’oxygène sur la circulation pulmonaire et la fonction ventriculaire chez des patients ayant une hypertension pulmonaire. Comparativement aux mesures de base, le protoxyde d’azote amena une petite différence statistiquement significative (P < 0.05) dans la pression artérielle movenne (76 ± 14 à 67 ± 12), la pression moyenne de l’artère pulmonaire (37 ± 14 à 33 ± 13 mmHg), et le débit cardiaque (3,7 ± 1,à 3,2 ± 1,1 L· min−1). L’administration de 70 pour cent d’air n’a pas amé de changement significatif comparativement au contrôle. L’administration de 100 pour cent d’oxygène a donné des valeurs approximativement identiques à celles lors de l’administration de protoxyde d’azote. On conclut que le protoxyde d’azote n’exacerbe pas l’hvpertension pulmonaire ou la dysfonction ventriculaire lors d’une anesthésie à haute dose de fentanyl chez les patients ayant une maladie valvulaire mitrale.

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Copyright information

© Canadian Anesthesiologists 1990

Authors and Affiliations

  • Steven N. Konstadt
    • 1
  • David L. Reich
    • 2
  • Daniel M. Thys
    • 2
  1. 1.Department of AnesthesiologyLoyola University Medical CenterMaywood
  2. 2.Department of AnesthesiologyMount Sinai Medical CenterUSA

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