Anesthesia Clinical Trial
Official title:
Relationship of Oxygenation During Anaesthesia in the Presence of N2O or N2 to Mode of Ventilation
Nitrous oxide is a standard part of most anaesthetic breathing mixtures. It has often been assumed that it reduces the amount of oxygen reaching the lower parts of the lung. However the results of previous studies and of some computer modelling suggests the opposite may be true, and that oxygen levels in the blood are actually higher with nitrous oxide. This study seeks to determine whether nitrous oxide increases or decreases blood oxygen levels in anaesthetized patients.
The concentrating and second gas effects of nitrous oxide (N2O) uptake have been well
described, and are produced by rapid uptake of N2O during the first several minutes of an
inhalational anesthetic. This significantly increases alveolar and arterial O2 partial
pressure. Theoretical modelling of alveolar gas exchange has predicted that these effects may
not be transient but may be a persisting phenomenon. However, N2O is known to promote
absorption atelectasis in poorly ventilated lung units.
This study, carried out pre-cardiopulmonary bypass in 20 patients undergoing coronary artery
surgery, measures change in PaO2 after a minimum of 30 minutes of relaxant general anesthesia
with a FIO2 of 30%. Patients are randomised to two groups. The intervention group has N2O
introduced following baseline blood gas measurements, while the control group continued
breathing an identical FIO2 in N2. The change in PaO2 in the two groups is the primary
endpoint for comparison.
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