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Canadian Journal of Anesthesia, Vol 28, 136-140, Copyright © 1981 by Canadian Anesthesiologists' Society

Probleme de la Diffusion Gazeuse Dans L'Oreille Moyenne au Cours de L'Anesthesie Pour Tympanoplastie

LUC PERREAULT M.D.1, PIERRE ROUSSEAU M.D.1, JEAN-FRANÇOIS GARNEAU M.D.1, and GUY FORGET M.D.2

1 Département d'Anesthésie Réanimation Service d'Otorhino-laryngologie, Hôpital Maisonneuve-Rosemont, Montréal
2 Service d'Otorhino-laryngologie, Hôpital Maisonneuve-Rosemont, Montréal

Adresse postale: Luc Perreault, M.D., Hôpital Maisonneuve-Rosemont, Département d'Anesthésie- Réanimation, 5415 boul. l'Assomption, Montréal, P.Q., Canada H1T 2M4.

The problems of diffusion of gas into the middle ear during anaesthesia have been described by several authors since 1965. The administration of anaesthetic concentrations of nitrous oxide raises middle ear pressure in the order of 3.43 to 3.92 kPa (350 to 400 mmH2O). This phenomenon disappears spontaneously after cessation of nitrous oxide anaesthesia and causes no trouble except a few cases of deafness and some rare tympanic ruptures. We have tried to solve this problem during anaesthesia for tympanoplasty by substituting air for nitrous oxide and by the use of ethrane as basic anaesthetic agent. Anaesthesia was potentiated by narcotics and the patients were adequately curarized. The results showed that this technique greatly reduced diffusion of gases if we kept the PaOO2 under 17.9 kPa (135 mmHg) and the PaCOCO2 at 3.9 kPa (30 mmHg). Controls have shown that diffusion is greater with higher PaCOCO2. Middle ear pressure, measured with Madsen impedence-meter, was not higher than 0.68 kPa (70 mmH2O).

Key Words: ANAESTHESIA, tympanoplasty • MIDDLE EAR, gas diffusion






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Copyright © 1981 by the Canadian Anesthesiologists' Society.