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Canadian Journal of Anesthesia, Vol 29, 435-438, Copyright © 1982 by Canadian Anesthesiologists' Society

Nitrous Oxide Administration in the Presence of Subcutaneous Emphysema: An Experimental Model

THOMAS J. POULTON M.D.1, LARRY W. HALDEMAN M.D.2, and EDWIN S. MUNSON M.D.3

1 Department of Anesthesiology, The Creighton University School of Medicine, Omaha, Nebraska
2 Pulmonary Medicine and Christmas Seal Fellow of the Florida Lung Association
3 Department of Anaesthesiology and the Division of Pulmonary Medicine, College of Medicine, University of Florida, Gainesville, Florida 32610

Address correspondence and reprint requests to Dr. T.J. Poulton, Department of Anesthesiology, The Creighton University School of Medicine, 601 North 30th Street, Omaha, Nebraska 68131, U.S.A.

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 ± 0.51 l/min to 2.40 ± 0.62 l/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.

Key Words: ANAESTHETICS, GASES, nitrous oxide • COMPLICATIONS, subcutaneous emphysema






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Copyright © 1982 by the Canadian Anesthesiologists' Society.