Nitrous Oxide

Used for: 

• Supplements the primary volatile maintenance agent (i.e., used in combination with sevoflurane or desflurane)

• Works to increase anesthetic depth 

• Cannot be used as the sole maintenance anesthetic due to its low potency (MAC = 104%)

Physiological effects:

• Minimal cardiovascular and respiratory effects 

Contraindications:

• Pulmonary hypertension 

Side effects:

• Postoperative nausea and vomiting

• Diffusion hypoxia: Nitrous oxide rapidly dissolves in body fluids. Upon cessation, the gas diffuses from the blood and into the alveoli. This dilutes the oxygen concentration in the alveoli and causes hypoxia. Administer 100% oxygen following nitrous oxide cessation.

• Bone marrow suppression (rare)