using Nitrous in Practice??

Re: using Nitrous in Practice??

nelly Franquet — Sat, 18 Jul 2009 19:06:00 GMT

we only use Iso and O2 in my clinic ...never nitrous .

Re: using Nitrous in Practice??

Fiona Leathers — Fri, 17 Jul 2009 15:19:34 GMT

Thats what I said! Tennis balls & marbles!!

Re: using Nitrous in Practice??

emvn80 — Wed, 15 Jul 2009 16:02:45 GMT

It's because nitrous is far more insoluble in blood than oxy, so it rapidly diffuses down its concentration gradient when it's turned off at the end (If you think that suddenly there is less nitrous in alveoli than blood and tissues so nitrous moves from blood to alveoli, then from tissues to blood etc). This happens much quicker with nitrous than oxygen etc because its so insoluble, so if you stopped the oxy and nitrous together at the same time, the nitrous would move from tissues and blood quicker than oxy leading potentially to a hypoxic mixture in lungs, ie hardly any oxy and lots of nitrous. This still happens when you turn off the nitrous but by supplying 100% oxy at this time instead of the 21% in room air there will still be enough inspired oxy to prevent a hypoxic mixture...

Inhalational anaesthesia is all about concentration gradients between alveoli, blood and tissues!

I hope this makes sense!

Re: using Nitrous in Practice??

Sandra Taylor RVN, MBVNA — Wed, 15 Jul 2009 15:00:42 GMT

[quote user="Bouncyfi"]

I always remember being told that nitrous molecoles are like big tennis balls and o2 molecules are like marbles, so the nitrous takes up more room in the lungs and thats why the nitrous needs to be switched off before the o2, so that the tennis balls can bugger and the lungs can fill with marbles again!!

Doesn't really make much sense written down but I've never forgotten it!

[/quote]

Makes perfect sense to me Fi

Re: using Nitrous in Practice??

Fiona Leathers — Wed, 15 Jul 2009 14:43:21 GMT

Doesn't really make much sense written down but I've never forgotten it!

Re: using Nitrous in Practice??

Nick Shackleton — Tue, 14 Jul 2009 21:13:35 GMT

Remember if using a circle system or humphrey you can use nitrous provided that you have capnography so that inspired gases can be monitored. Also should only be used in 50/50 mix when using with the two above circuits.

Also remember should not be used in patients that respiratory comprimised or those with gas filled pockets eg Gastric Torsion and pneumothorax as the Nitrous rushes in and fills the space faster than nitrogen can leave the pocket therefore distending it furthur with catastrophic consequencies

Re: using Nitrous in Practice??

wobbliebob — Tue, 14 Jul 2009 20:59:30 GMT

yep we use for everything other than those mentioned above. It is fab for ortho surgeries and def uses less iso.

Re: using Nitrous in Practice??

Sal the 1st — Tue, 14 Jul 2009 20:40:19 GMT

sorry have just reread my post should be 1/3 oxygen ;2/3 nitrous - have just realised I have put ti the wrong way round!

Re: using Nitrous in Practice??

scubamoo — Tue, 14 Jul 2009 17:42:59 GMT

Hi There

We use nitrous routinely, I think its really good especially for bitch spays when the vets start pulling on the ovaries.... I either use it 1/2 and 1/2 with oxygen or 2/3 n2o and 1/3 o2. You can usually lower the amount of iso that you use. It is contraindicated where there is blockage i.e GDV, Intussuceptions and caesars.

I use it with either mini lack or parallel lack, I seem to remember that you shouldn't use it with closed circuits.

I always turn off n20 5-10 minutes before turning off the iso so the animals can vent off.

The other thing i have noticed is the animals do go a little paler than with just iso.

We routinely monitor iso and n2o yearly and don't have a problem with exposure.

Re: using Nitrous in Practice??

Cat Woman — Tue, 14 Jul 2009 17:13:38 GMT

Can't really remember much about using it! Sorry! Do remember tho, that it greatly reduced the amount of iso we used.

Re: using Nitrous in Practice??

Sal the 1st — Tue, 14 Jul 2009 16:39:39 GMT

make sure you knock off the nitrous and put the O2 up to 100% about 10 mins before end of op - or should I say 10 mins before you want the animal to start waking up. Not adviseable to use in abdominal ops. You need to monitor operator exposure.

most places I have worked have used 1/3 and 2/3 mix nitrous /oxygen but have worked places that use a 50/50 mix