![]() ![]() megaloblastic anemia via bone marrow suppression.teratogenicity – there is very little data supporting this.Below lists risks associated (which are of particular note in patients with pernicious anemia, vegans, and hx of alcohol abuse): B12 inhibits methionine synthase – an enzyme needed for myelin production and folate metabolism. CBF and CMRO2 are both elevated, but CMRO2 rises disproportionately more than CBF.Ĭauses decreased renal blood flow secondary to increased renal vascular resistance Reduces cerebral vascular tone and uncouples CBF and CMRO2. This is NOT so much a concern in healthy patients, but should be of greater concern in patients that have conditions where oxygen exchange is challenged (COPD, etc).Īccording to Chu & Fuller, there is no clear reason to omit nitrous oxide from laparoscopic surgeries (contrary to the popular belief that nitrous will expand the gases used to inflate the peritoneum).Ĭauses myocardial depression in the presence of heart failure, especially when administered with opioids. The iconic time that this happens is when the nitrous has been discontinued and the patient is emerging. This reduces alveolar O2 concentrations and leads to hypoxemia – especially so if the patient is on room air. Diffusion hypoxemia happens when the rapid elimination of nitrous oxide from the blood to the alveoli displaces the oxygen. When discontinuing nitrous oxide, put the patient on 100% O2. ![]() See the article hereĬan cause diffusion hypoxemia. It has been shown that if nitrous oxide administration stays under 1 hour, there is very little chance of it causing PONV. There’s still a lot of concern surrounding nitrous oxide causing PONV. Increases pulmonary vascular resistance (PVR) Nitrous Oxide, when used as the SOLE agent, actually activates the SNS, which increases SVR, CVP, and arterial pressure A 2:1 (67%) nitrous mix can triple the airspace. Compliant air spaces such as a pneumothorax can double with a 1:1 (50%) nitrous mix. Used as an adjuvant to other anesthetics.ģ0 times more soluble than nitrogen and will rapidly diffuse into and expand any air-filled space. Since it’s MAC value is 104%, it cannot be used as the sole anesthetic agent. Sedation onset and offset both are very quick. ![]()
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