Risks and Benefits of Nitrous Oxide in General Anesthesia

Abstract

  Nitrous oxide has often been used as a basic component of general anesthesia. As the recognition of possible adverse effects and environmental pollution from nitrous oxide have increased remarkably, the use of this important carrier gas has become increasingly limited. Moreover, the development of new volatile and intravenous anesthetics has led to calls for a re-evaluation of the role of nitrous oxide in current anesthetic practice. Nitrous oxide does increase the incidence of postoperative nausea and vomiting, but it seems that use of antiemetics prophylactically prevents this side effect. By enabling reduced doses of more potent anesthetics, nitrous oxide limits other cardiorespiratory side effects as well. The greatest reason for the continued use of nitrous oxide is that it has been reported to reduce the incidence of intraoperative awareness because it has a superior amnesic effect compared with other volatile anesthetics. There are specific contraindications for the use of nitrous oxide, but in the absence of these, it is difficult to justify not using it.