TYK93
All of the following are ABSOLUTE contraindactions for use of nitrous oxide in anesthesia EXCEPT:
A. Known deficiency of enzyme or substrate in methionine synthase pathway
B. Potential toxicity from expansion of gas filled space, e.g., emphysema, pneumothorax, middle ear surgery, pneumocephalus, air embolus
C. Raised intracranial pressure
D. Pulmonary hypertension
Answer
The answer is D.
Ok, so I didn't make this stuff up. This comes from a review article[1] about the toxicity of nitrous oxide. This article is a review in response to the ENIGMA study and does a great job of stating the effects of nitrous oxide. While nitrous oxide remains a relatively safe anesthetic choice, there are some instances that may preclude its use. Good ones to know. Some of the others are theoretical or unproven. Enjoy.
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