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dc.contributor.authorPeyton, Philip Jen
dc.contributor.authorHorriat, Maryamen
dc.contributor.authorRobinson, Gavin J Ben
dc.contributor.authorPierce, Robert Jen
dc.contributor.authorThompson, Bruce Ren
dc.identifier.citationAnesthesiology; 108(3): 381-7en
dc.description.abstractA number of studies have demonstrated a faster rate of increase in end-expired partial pressure as a fraction of inspired (Pa/Pi) for volatile agents in the presence of high concentrations of nitrous oxide, consistent with the second gas effect. However, no study has demonstrated a similar effect on arterial blood concentrations.The authors compared arterial and end-tidal partial pressures of sevoflurane (Pa/Pisevo and Pa/Pisevo) in 14 patients for 30 min after introduction of either 70% nitrous oxide or nitrous oxide-free gas mixtures to determine the magnitude of the second gas effect. Blood partial pressures were measured using a double headspace equilibration technique.Both Pa/Pisevo and Pa/Pisevo were significantly higher in the nitrous oxide group than in the control group (P < 0.001 on two-way analysis of variance). This difference was significantly greater (P < 0.05) for Pa/Pisevo (23.6% higher in the nitrous oxide group at 2 min, declining to 12.5% at 30 min) than for Pa/Pisevo (9.8% higher in the nitrous oxide group at 2 min) and was accompanied by a significantly lower Bispectral Index score at 5 min (40.7 vs. 25.4; P = 0.004).Nitrous oxide uptake exerts a significant second gas effect on arterial sevoflurane partial pressures. This effect is two to three times more powerful than the effect on end-expired partial pressures. The authors explain how this is due to the influence of ventilation-perfusion scatter on the distribution of blood flow and gas uptake in the lung.en
dc.subject.otherAged, 80 and overen
dc.subject.otherAnesthesia, Inhalation.methodsen
dc.subject.otherBlood Gas Analysis.methodsen
dc.subject.otherCatheters, Indwellingen
dc.subject.otherExhalation.drug effects.physiologyen
dc.subject.otherMethyl Ethers.blooden
dc.subject.otherMiddle Ageden
dc.subject.otherNitrous Oxide.blood.pharmacokineticsen
dc.subject.otherPartial Pressureen
dc.titleMagnitude of the second gas effect on arterial sevoflurane partial pressure.en
dc.typeJournal Articleen
dc.identifier.affiliationDepartment of Anaesthesia, Austin Hospital, Heidelberg, Melbourne, Australiaen
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