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Canadian Journal of Anesthesia, Vol 29, 428-434, Copyright © 1982 by Canadian Anesthesiologists' Society

Middle Ear Pressure Variations During Nitrous Oxide and Oxygen Anaesthesia

LUC PERREAULT M.D.1, NICOLE NORMANDIN M.O.A.2, LYNE PLAMONDON B.Sc., O.A.2, ROBERT BLAIN M.D.1, PIERRE ROUSSEAU M.D.1, MICHEL GIRARD M.D.1, and GUY FORGET M.D.3

1 Department of Anaesthesia, Maisonneuve-Rosemont Hospital; Department of Anaesthesia, School of Medicine, University of Montreal
2 Ecole d'Orthophonie et d'Audiologie, School of Medicine, University of Montreal
3 Department of Oto-Rhino-Laryngology, Maisonneuve-Rosemont Hospital; Department of Oto-Rhino-Laryngology, School of Medicine, University of Montreal

Mailing Address: Luc Perreault, M.D., Department of Anaesthesia, Maisonneuve-Rosemont Hospital, 5415, l'Assomption blvd, Montreal, P.Q. H1T 2M4.

Many authors have reported middle ear pressure variations during inhalation of high concentrations of nitrous oxide. An on-going study on subjects anaesthetized with nitrous oxide and oxygen supplemented with halogens or narcotics and excluding operations on the ear enables us to register three typical curves of middle ear pressure according to the patency of the Eustachian tube. We recorded significant negative middle ear pressures during the recovery period when there was important obstruction of the Eustachian tube.

The presence of a tympanic "neomembrane" due to an old perforation associated with important obstruction of the Eustachian tube could lead to a tympanic perforation that may be unnoticed by the anaesthetist if it is not specifically investigated. In our series, we report one case of tympanic perforation and one case of haemotympanum as examples of such consequences.

Key Words: ANAESTHETICS, GASES, nitrous oxide • COMPLICATIONS, middle ear pressure changes






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Copyright © 1982 by the Canadian Anesthesiologists' Society.