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Title: European Society of Anaesthesiology Task Force on Nitrous Oxide: a narrative review of its role in clinical practice.
Austin Authors: Buhre, Wolfgang;Disma, Nicola;Hendrickx, Jan;DeHert, Stefan;Hollmann, Markus W;Huhn, Ragnar;Jakobsson, Jan;Nagele, Peter;Peyton, Philip J ;Vutskits, Laszlo
Affiliation: Department of Anesthesiology and Pain Medicine, Maastricht University Medical Center, University of Maastricht, Maastricht, the Netherlands
Department of Anesthesia, Istituto Giannina Gaslini, Genoa, Italy
Department of Anesthesiology, Amsterdam University Medical Center (AUMC), AMC, University of Amsterdam, Amsterdam, the Netherlands
Anaesthesia Perioperative and Pain Medicine Unit, Melbourne Medical School, University of Melbourne, Melbourne, Australia
Department of Anesthesiology, University Hospital Düsseldorf, Düsseldorf, Germany
Department of Anesthesiology, Onze-Lieve-Vrouwziekenhuis Hospital Aalst, Aalst, Belgium
Department of Anesthesiology and Perioperative Medicine, University Hospital Ghent, Ghent, Belgium
Department of Anesthesiology and Intensive Care, Institution for Clinical Science, Karolinska Institute, Danderyds University Hospital, Danderyd, Sweden
Department of Anesthesia and Critical Care, University of Chicago Medicine, Chicago, IL, USA
Department of Anesthesiology, Pharmacology and Intensive Care, University Hospitals Geneva, Genève, Switzerland
Department of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia
Issue Date: 21-Feb-2019
Date: 2019
Publication information: British journal of anaesthesia 2019; 122(5): 587-604
Abstract: Nitrous oxide (N2O) is one of the oldest drugs still in use in medicine. Despite its superior pharmacokinetic properties, controversy remains over its continued use in clinical practice, reflecting in part significant improvements in the pharmacology of other anaesthetic agents and developing awareness of its shortcomings. This narrative review describes current knowledge regarding the clinical use of N2O based on a systematic and critical analysis of the available scientific literature. The pharmacological properties of N2O are reviewed in detail along with current evidence for the indications and contraindications of this drug in specific settings, both in perioperative care and in procedural sedation. Novel potential applications for N2O for the prevention or treatment of chronic pain and depression are also discussed. In view of the available evidence, we recommend that the supply of N2O in hospitals be maintained while encouraging its economic delivery using modern low flow delivery systems. Future research into its potential novel applications in prevention or treatment of chronic conditions should be pursued to better identify its role place in the developing era of precision medicine.
DOI: 10.1016/j.bja.2019.01.023
Journal: British journal of anaesthesia
PubMed URL: 30916011
Type: Journal Article
Subjects: anaesthesia
dental pain
labour analgesia
major depression
nitrous oxide
Appears in Collections:Journal articles

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