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British Journal of Anaesthesia, 1986, Vol. 58, No. 10 1122-1129
© 1986 The Board of Management and Trustees of the British Journal of Anaesthesia

other

RESPIRATORY EFFECTS OF NITROUS OXIDE DURING ISOFLURANE ANAESTHESIA IN CHILDREN

I. MURAT, M.D., J. P. SAINT-MAURICE, M.D., L. BEYDON, M.D. and K. MACGEE, M.D.

Departement d'Anesthesie-Réanimation Chirurgicale, Hopital Saint-Vincent-de-Paul 74, avenue Denfert-Rochereau, 75674 Paris Cedex 14, France

Respiratory effects of nitrous oxide and isoflurane were studied in 13 children (mean age 45.6± 19.3 months, mean weight 14.9±4.8kg) during surgery under continuous extradural anaesthesia. Three different anaesthetic states were studied: (1) isoflurane 0.5 MAC in oxygen (27 study periods), (2) isoflurane 0.5 MAC with 50% nitrous oxide (32), (3) isoflurane 1 MAC in oxygen (25). End-tidal carbon dioxide (PE1CO2) and isoflurane, respiratory indices (tidal volume, VT; minute ventilation, VE; mean inspiratory flow, VI; respiratory frequency f, effective inspiratory timing T1/Ttot were measured. The addition of nitrous oxide (comparison of respiratory variables obtained in 25 successive periods at(1) and (2)) produced a significant increase in PE'CO2 significant decreases in VT, VE and VI, a significant increase in f. The increase in alveolar concentration of isoflurane ((1) compared with (3) in 25 successive periods) was associated with a significant increase in PE'CO2 significant decreases in VT, VE, VI and a significant increase in f. The equipotent anaesthetic states (2) and (3) were compared in 21 successive periods. In children, the net result of substituting nitrous oxide for an equal MA C fraction of isoflurane was to produce a smaller decrease in Vr responsible for a smaller decrease in VE without significant change in respiratory rate.


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