Abstract
Adverse effects may occur when patients with air in the pleural space or in the cerebral ventricles breathe nitrous oxide. We developed an animal model to learn whether similar adverse effects are associated with the inhalation of nitrous oxide when air is present in the subcutaneous space. We induced extensive subcutaneous emphysema in swine and measured oxygen and carbon dioxide tensions in systemic arterial and mixed venous blood; cardiac output; intravascular, airway, and pre-sternal subcutaneous pressures; total pulmonary-thoracic static compliance; and thoracic girth before and after a 45 minute period of breathing 75 per cent nitrous oxide in oxygen. Cardiac output decreased from 3.13 ± 0.511/min to 2.40 ± 0.621/min (p < 0.05); no other values changed significantly. No significant adverse cardiorespiratory effects resulted from the transfer of inhaled nitrous oxide to the subcutaneous space in this animal model.
Résumé
On connait les effets nocifs de l’inhalation de protoxyde d’azote chez les patients dont les espaces pleuraux ou les cavités ventriculaires cérébrales contiennent déjà de l’air. Nous avons créé un modèle animal pour savoir si des effets de même type pouvaient être associé à l’inhalation de protoxyde d’azote lorsque l’espace sous-cutané contient de l’air. Nous avons provoqué un emphysène dans le tissus sous-cutané étendu du porc et mesuré les tensions en oxygène et en gaz carbonique du sang artériel et veineux mêlé, le débit cardiaque, les pressions intra-vasculaires, respiratoires et présternales sous-cutanées, la compliance statique pulmonaire-thoracique totale, et le tour de poitrine avant et après une période de 45 minutes d’inhalation de protoxyde d’azote à 75 pour cent dans l’oxygène. Le débit cardiaque a diminué de 3.13 ± 0.511/min à 2.40 ± 0.621/min (p < 0.05); toutes les autres valeurs se sont maintenues. Aucune réaction cardio-pulmonaire défavorable n’a suivi le transfert de protoxyde d’azote à l’espace sous-cutané sur ce modèle animal.
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References
Munson, E.S. Transfer of nitrous oxide into body air cavities. Br. J. Anaesth.46: 202–208 (1974).
Eger, E.I. &Saidman, L.J. Hazards of nitrous oxide anesthesia in bowel obstruction and pneumothorax. Anesthesiology26: 61–66 (1965).
Christian, M.S., Munson, E.S. &Hamilton, W.K. Pneumothorax following induction of anesthesia. JAMA209: 1710–1711 (1969).
Saidman, L.J. &Eger, E.L. Changes in cerebrospinal fluid pressure during pneumoencephalography under nitrous oxide anesthesia. Anesthesiology26: 67–72 (1965).
Rosenberg, M.B., Wunderlich, B.K. &Reynolds, R.N. Iatrogenic subcutaneous emphysema during dental anesthesia. Anesthesiology51: 80–81 (1979).
Milne, B., Katz, H., Rosales, J.K., Assimes, I.K. &Schwartz, S. Subcutaneous facial emphysema complicating dental anesthesia. Can. Anaesth. Soc. J.29: 71–73 (1982).
Severinghaus, J.W. Blood gas calculator. J. Appl. Physiol.21: 1108–1116 (1966).
Grabb, W.C. &Myers, B.M. (eds). Skin Flaps. Boston: Little Brown and Co. (1975).
Matz, G.J., Rattenborg, C.G. &Holaday, D.A. Effects of nitrous oxide on middle ear pressure. Anesthesiology28: 948–950 (1967).
Bailie, M.D., Alward, C.T., Sawyer, D.C.,et al. Effect of anesthesia on cardiovascular and renal function in the newborn piglet. J. Pharmacol. Exp. Ther.208: 298–302 (1979).
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Poulton, T.J., Haldeman, L.W. & Munson, E.S. Nitrous oxide administration in the presence of subcutaneous emphysema: An experimental model. Canad. Anaesth. Soc. J. 29, 435–438 (1982). https://doi.org/10.1007/BF03009405
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DOI: https://doi.org/10.1007/BF03009405