nitrous oxide

Re: nitrous oxide

wilkoannie — Sat, 07 Sep 2013 12:28:26 GMT

Thank you nick

brilliant advice and thanks for reply

Re: nitrous oxide

Carolyn Edwards — Fri, 06 Sep 2013 21:52:45 GMT

I've been told it's fine to keep using nitrous until all painful procedures, including skin closure, have been completed. You can still supplement with oxygen using a mask if you've extubated the patient before it's had less than 10 minutes off N2O.

Re: nitrous oxide

Nick Shackleton — Thu, 05 Sep 2013 21:06:47 GMT

[quote user="craig_mcdonald1"]sort of off subject but I found it funny when I was at uni and every book you look in says the normal parameters for species are slightly different, then on exam you have to pick which one is normal temperature range for the dog etc I'm sure that dogs don't evolve and change their normal heart rate or temperature every year but the range seems to be always updating or written slightly different.

[/quote] Too true lol

Re: nitrous oxide

Craig McDonald — Thu, 05 Sep 2013 20:56:42 GMT

sort of off subject but I found it funny when I was at uni and every book you look in says the normal parameters for species are slightly different, then on exam you have to pick which one is normal temperature range for the dog etc I'm sure that dogs don't evolve and change their normal heart rate or temperature every year but the range seems to be always updating or written slightly different.

Re: nitrous oxide

Nick Shackleton — Wed, 04 Sep 2013 22:26:46 GMT

Personally I can't see how things can of changed unless dogs and cats have some how evolved.........

Re: nitrous oxide

Craig McDonald — Wed, 04 Sep 2013 20:51:32 GMT

Thanks Nick this is exactly as I understood it, I shall ask the nurse for the information she has on its use she had a booklet for a CPD talk she went to - Hopefully she will be able to dig it out for me

Re: nitrous oxide

Nick Shackleton — Tue, 03 Sep 2013 22:48:21 GMT

Ø Risk of diffusion (dilutional) hypoxia. This occurs at the time when the nitrous oxide is turned off and the patient is disconnected from the breathing circuit and starts to breathe room air (21% oxygen). Nitrous oxide is usually used in large volumes during anesthesia (> 50%), and when it is turned off its uptake is reversed and it moves from the blood to the alveoli. Thus, during the first 5 to 10 minutes after discontinuing the nitrous oxide, the volume moving into the lung is large and dilutes the oxygen in the alveoli. If breathing room air, this may result in hypoxia. To avoid dilutional hypoxia, the animal should breathe 100% oxygen for the first 5-10 minutes after discontinuing nitrous oxide. http://www.vetequip.com/knowledge/knowPharm-Inh_Anes.htm printed 2002 so slightly dated will continue the search

Re: nitrous oxide

Nick Shackleton — Tue, 03 Sep 2013 22:41:42 GMT

You need good active scavenging, so I can kinda see the H&S point of view. I was always taught either 2:1 or 1:1 dependant on patient I was always taught turn off 10 mins before end of procedure so used to be either whilst doing post op rads or whilst muscle layer was being closed dependant on size of wound. Would be interested to see the research behind what you've been told........ Off to look. Remember "googles not good enough" lol

Re: nitrous oxide

Craig McDonald — Tue, 03 Sep 2013 22:31:49 GMT

We used to have N2O only a couple of months ago head office discontinued it's use in our hospitals, said about staff H&S and risks but I couldn't see any greater risk than with Iso alone? It was amazing, I'm a massive fan of it I used to use it in bitch spays and they were really settled and was really good as well as for orthopaedics and good for those patients that just wont settle. I was always told that need a minimum of 30% O2 when using it and was told that needs to be turned off 10% before end of op because of diffusion hypoxia (Fink effect) but one of the nurses said that you now don't need to turn it off 10mins before the end of the op? Anyone see any research about this?

Re: nitrous oxide

Nick Shackleton — Mon, 02 Sep 2013 22:22:02 GMT

I liked using nitrous oxide in combination with other alnagesia especially ortho cases. Used to use with circle circuit 50/50 and then non-rebreathing systems 2:1 nitrous:oxygen. Used to turn nitrous off whilst doing post rads. Just certain cases where it shouldn't be used such as cases involving gas filled structures, such as GDV as nitrous oxide will exacerbate the already bloated stomach. Also any thoracic surgery or where the patient has thoracic impairments. If in doubt ask your vet before administering. Good luck. Love the stuff. Not personally, but from an anaesthesia point of view

Re: nitrous oxide

laura dickenson — Thu, 29 Aug 2013 12:55:10 GMT

I have just moved into a practice and we use nitrous. It is fab. Ive never used it before but I can see why it is used.

You use a ratio of 2:1 nitrous to o2.

Your iso can be used at a much lower rate (between 1.5 - 1%)

Turn off your nitrous 10mins before turning off isoflurane,

Then when you turn of your iso your patient wakes up very quickly. Although we use ventilators so this also means they wake up quickly.

Hope this helps

The 'hangover effect' seems less also.