Wednesday, 26 March 2014

De Vasconcellos K & Sneyd JR. Nitrous oxide: are we still in equipoise? A qualitative review of current controversies. BJA (2013), 111(6): 877-85.

This review article looks at the current position of nitrous oxide in anaesthetic practice, The article compare its relative advantages and disadvantages – the classically known ones which we are all aware of from our primary exams such as diffusion hypoxia, expansion of gas-fille spaces, postoperative nausea and vomiting to more recent concerns with neurotoxicity, wound complications and adverse cardiovascular outcomes. The authors also review recent suggested beneficial effects on the central nervous system, cardiovascular system, reduction of awareness with recall and pain (both acute and chronic) and argue that although nitrous oxide has fallen out of favour in the practice of many anaesthetists, we should re-consider current evidence and any new data (eg. ENIGMA-II) and consider nitrous oxide an option. GK

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