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British Journal of Anaesthesia, 2001, Vol. 87, No. 6 894-896
© 2001 The Board of Management and Trustees of the British Journal of Anaesthesia

Laboratory Investigations

Diffusion of nitrous oxide into the pleural cavity{dagger}

S. Kaur*, J. Cortiella and C. A. Vacanti

Department of Anesthesiology, UMass Memorial Medical Center, University Campus, 55 Lake Avenue North, Worcester, MA 01655, USA*Corresponding author

{dagger}Presented in part at the Annual Meeting of the American Society of Anesthesiologists, Orlando, FL, October 17–21, 1998.

We postulated that nitrous oxide transfer into the pleural cavity can occur by diffusion from the alveoli, independent of vascular transport. Under general anaesthesia, six sheep were studied in two phases, a control and an experimental phase. The sheep were anaesthetized, intubated, and received positive pressure mechanical ventilation. A catheter was placed in the right pleural cavity and 150 ml air injected. The animals were ventilated with 100% oxygen. The inspired gas was changed to a mixture of 50% nitrous oxide and 50% oxygen, and the rate of increase of nitrous oxide concentration in the pleural space was measured. The animals were then ventilated with 100% oxygen and then killed by exsanguination while ventilation was continued. The inspired mixture was changed to 50% nitrous oxide and 50% oxygen and the rate of increase in nitrous oxide concentration was measured in the pleural space again. During venitilation with nitrous oxide in the living animals, the concentration of nitrous oxide in the pleural cavity increased rapidly and decreased to zero during ventilation with 100% oxygen. During ventilation without circulation, the rate of increase in the concentration of nitrous oxide in the pleural cavity was the same as in the control phase. This suggests that nitrous oxide enters the pleural space by diffusion, rather than by vascular delivery. This mechanism may explain the rapid increase in the volume of pneumothorax if nitrous oxide is given in the inspired gas.

Br J Anaesth 2001; 87: 894–6


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