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Acta Anaesthesiol. Sin. · Jun 2001
Randomized Controlled Trial Clinical TrialOxygen in nitrogen versus nitrous oxide during pediatric general anesthesia.
- T Elwood and E Hutchinson.
- Department of Anesthesiology, University of Washington School of Medicine & Children's Hospital and Regional Medical Center, Seattle, Washington, USA. telwoo@chmc.org
- Acta Anaesthesiol. Sin. 2001 Jun 1; 39 (2): 59-64.
BackgroundInduction of anesthesia decreases lung volumes, giving areas of non-ventilated lung. Nitrogen is a slowly-absorbed gas that could prevent resorption of gases from these closed spaces, preventing atelectasis and improving oxygen saturations during recovery.MethodsWe evaluated oxygen saturations during emergence after intra-operative administration of 33% oxygen in nitrogen versus 33% oxygen in nitrous oxide in 62 children having elective urologic surgery. Patients were randomly assigned to either group A (2.5 L/min air with 0.5 L/min oxygen) or group N (2 L/min nitrous oxide and 1 L/min oxygen). Flowmeters were covered to maintain blinding. Anesthetic technique was standardized (laryngeal mask airway, caudal, halothane, and deep extubation). Patients breathed room air during emergence, while a blinded observer recorded duration of desaturations by stopwatch for 15 min.ResultsWe found similar desaturations in both groups. The difference in desaturations < 94% at an interim 2-min total probably reflects diffusion hypoxia and was not significant at 15 min. The frequency of desaturations < 87% during emergence was significantly greater in children who were crying during induction.ConclusionsThe intra-operative use of air versus nitrous oxide has no substantial effect on oxygen saturations during emergence from anesthesia in children. These results are consistent with a recently published mathematical model.
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