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British Journal of Anaesthesia 2008 100(2):203-210; doi:10.1093/bja/aem369
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2008. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Comparison of the sedative, cognitive, and analgesic effects of nitrous oxide, sevoflurane, and ethanol

R. Duarte1, A. McNeill1, G. Drummond2,* and B. Tiplady2

1 Department of Neuroscience, 1 George Square, Edinburgh EH8 9JZ, UK
2 Department of Anaesthesia, Critical Care, and Pain Medicine, University of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, UK

* Corresponding author. E-mail: g.b.drummond{at}ed.ac.uk

Background: Anaesthetics which work by different mechanisms may have different patterns of effect. Measurement of these patterns thus may elucidate their mechanisms of action and allow therapeutic choices between the agents.

Methods: We compared the effects of ethanol (~80 mg per 100 ml), and different end-tidal concentrations of nitrous oxide (15% and 25%) and sevoflurane (0.3% and 0.5%) in volunteers. We measured speed and accuracy in psychomotor tests, reaction time and memory, touch and pain sensitivity to von Frey filaments, and subjective mood for a range of descriptors.

Results: All treatments caused the same degree of overall abnormal feelings, but sevoflurane caused more obtunding (subjective drowsiness, slow reaction times, and loss of memory function) and nitrous oxide was more analgesic. Ethanol caused a marked feeling of drunkenness, but little drowsiness or analgesia.

Conclusions: In the same volunteer subjects, direct comparison of sub-anaesthetic doses of these agents showed a clear and characteristic pattern of effects. These support the possible mechanisms for these disparate agents and may help choose appropriate agents for specific desired anaesthetic outcomes such as sedation or analgesia.

Keywords: anaesthetics gases, nitrous oxide; anaesthetics volatile, sevoflurane; ethanol; measurement techniques, visual analogue scale; psychological responses


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