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Die Anaesthesiologie
Erschienen in: Der Anaesthesist 9/2004

01.09.2004 | Leitthema

Lachgas

Sinn oder Unsinn für die heutige Narkoseführung

verfasst von: M. E. Schönherr, PD Dr. med. Dr. rer. nat. M. W. Hollmann, B. Graf

Erschienen in: Die Anaesthesiologie | Ausgabe 9/2004

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Zusammenfassung

Aufgrund seiner günstigen physikalischen Eigenschaften und geringen kardiovaskulären Nebenwirkungen galt Lachgas (N2O) lange Zeit als ideales Narkosegas; es wird seit 150 Jahren zur inhalativen Analgesie und Hypnose bei der Allgemeinanästhesie in Kombination mit volatilen Anästhetika, aber auch zur kurzfristigen Analgosedierung eingesetzt. Bis heute ist der genaue Wirkmechanismus nicht geklärt, relevante Komplikationen beim N2O-Einsatz sind jedoch bekannt. Die Einführung neuer Narkosegase sowie kurz wirksamer Opiate hat zu einer zunehmend kritischen Bewertung der N2O-Anwendung geführt. Lachgas hat jedoch nach wie vor einen Stellenwert im Rahmen der Kinderanästhesie zur Maskeneinleitung sowie in der Geburtshilfe. Neuere Untersuchungen zeigen, dass es durch den Verzicht auf N2O zu einer erhöhten Rate an intraoperativer Wachheit („awareness“) kommen kann. Unter sorgfältiger Berücksichtigung der dargestellten Kontraindikationen und Nebenwirkungen sowie nach Abwägung der verfügbaren Alternativen stellt N2O auch heute noch eine Option im Rahmen einer Allgemeinanästhesie dar.
Literatur
1.
Abballe C, Camaioni D, Mascaro A, Boccardi M, Evangelista M (1993) Anesthesia for laparoscopic cholecystectomy: the use of nitrous oxide in the anesthetic mixture. G Chir 14:493–495PubMed
2.
Apfel CC, Roewer N (2000) Einflußfaktoren von Übelkeit und Erbrechen nach Narkosen. Anaesthesist 49:629–642CrossRefPubMed
3.
4.
Apfel CC, Läärä E, Koivuranta M, Greim CA, Roewer N (1999) A simplified risk score for predicting postoperative nausea and vomiting: conclusions from cross-validations between two centers. Anesthesiology 91:693–700CrossRefPubMed
5.
Apfel CC, Korttila K, Abdalla M et al. (2004) A factorial trial of six interventions for the prevention of postoperative nausea and vomiting. N Engl J Med 350:2441–2451CrossRefPubMed
6.
Astrom S, Kjellgren D, Monestam E, Backlund U (2003) Nitrous oxide anesthesia and intravitreal gastamponade. Acta Anaesthesiol Scand 47:361–362PubMed
7.
Badner NH, Drader K, Freeman D, Spence JD (1998) The use of intraoperative nitrous oxide leads to postoperative increases in plasma homocysteine. Anesth Analg 87:711–713CrossRefPubMed
8.
Badner NH, Beattie WS, Freeman D, Spence JD (2000) Nitrous oxide-induced increased homocysteine concentrations are associated with increased postoperative myocardial ischemia in patients undergoing carotid endarterectomy. Anesth Analg 91:1073–1079CrossRefPubMed
9.
Badner NH, Freeman D, Spence JD (2001) Preoperative oral B vitamins prevent nitrous oxide-induced postoperative plasma homocysteine increases. Anesth Analg 93:1507–1510CrossRefPubMed
10.
Balasaraswathi K, Kumar P, Rao TL, El-Etr AA (1981) Left ventricular end-diastolic pressure (LVEDP) as an index for nitrous oxide use during coronary artery surgery. Anesthesiology 55:708–709PubMed
11.
Baskett PJ (1994) Nitrous oxide in pre-hospital care. Acta Anaesthesiol Scand 38:775–776
12.
Baum J, Sievert B, Stanke H-G, Brauer K, Sachs G (2000) Lachgasfreie Niedrigflußnarkosen. Anaesthesiol Reanimat 25:60–67
13.
Baur CP, Klingler W, Jurkat-Rott K et al. (2000) Xenon does not induce contracture in human malignant hyperthermia muscle. Br J Anaesth 85:712–716CrossRefPubMed
14.
Berkowitz BA, Finck AD, Ngai SH (1977) Nitrous oxide analgesia: reversal by naloxone and development of tolerance. J Pharmacol Exp Ther 203:539–547PubMed
15.
Bindslev L, Cannon D, Sykes MK (1986) Reversal of nitrous oxide-induced depression of hypoxic pulmonary vasoconstriction by lignocaine hydrochloride during collapse and ventilation hypoxia of the left lower lobe. Br J Anaesth 58:451–456PubMed
16.
Blackstock D, Gettes MA (1986) Negative pressure in the middle ear in children after nitrous oxide anaesthesia. Can Anaesth Soc J 33:32–35PubMed
17.
Burkhardt-His M (1873) Erfahrungen über die Anwendung des Stickoxydulgases als Anaestheticum. Correspondenzblatt für Schweizer Ärzte 11:283–285
18.
Cahalan MK, Weiskopf RB, Eger EI 2nd et al. (1991) Hemodynamic effects of desflurane/nitrous oxide anesthesia in volunteers. Anesth Analg 73:157–164PubMed
19.
Carton EG, Housmans PR (1992) Role of transsarcolemmal Ca2+ entry in the negative inotropic effect of nitrous oxide in isolated ferret myocardium. Anesth Analg 74:575–579PubMed
20.
Chambers JC, McGregor A, Jean-Marie J, Kooner JS (1998) Acute hyperhomocysteinaemia and endothelial dysfunction. Lancet 351:36–37
21.
Chambers JC, McGregor A, Jean-Marie J, Obeid OA, Kooner JS (1999) Demonstration of rapid onset vascular endothelial dysfunction after homocysteinemia: an effect reversible with vitamin C therapy. Circulation 99:1156–1160PubMed
22.
Chapman CR, Benedetti C (1979) Nitrous oxide effects on cerebral evoked potential to pain: partial reversal with a narcotic antagonist. Anesthesiology 51:135–138PubMed
23.
Christensen B, Refsum H, Garras A, Ueland PM (1992) Homocysteine remethylation during nitrous oxide exposure of cells cultured in media containing various concentration of folates. J Pharmacol Exp Ther 261:1096–1105PubMed
24.
Christensen B, Guttormsen AB, Schneede J, Riedel B, Refsum H, Svardal A, Ueland PM (1994) Preoperative methionine loading enhances restoration of the cobalamin-dependent enzyme methionine synthase after nitrous oxide anesthesia. Anesthesiology 80:1046–1056
25.
Cohen EN, Bellville JB, Brown BW (1971) Anesthesia, pregnancy, and miscarriage: a study of operating room nurses and anesthetists. Anesthesiology 35:343–347PubMed
26.
Cohen EN, Brown BW, Bruce DL (1975) A survey of anesthetic health hazards among dentists. J Am Dent Assoc 90:1291–1296PubMed
27.
Constant I, Abbas M, Boucheseiche S, Laude D, Murat I (2002) Non-invasive assessment of cardiovascular autonomic activity induced by brief exposure to 50% nitrous oxide in children. Br J Anaesth 88:637–643CrossRefPubMed
28.
Deutsch G, Samra SK (1990) Effects of nitrous oxide on global and regional cortical blood flow. Stroke 21:1293–1298PubMed
29.
Deutsch S, Bastron RD, Pierce EC Jr, Vandam LD (1969) The effects of anaesthesia with thiopentone, nitrous oxide, narcotics and neuromuscular blocking drugs on renal function in normal man. Br J Anaesth 41:807–815PubMed
30.
Divatia VJ, Vaidya JS, Badwe RA, Hawaldar RW (1996) Omission of nitrous oxide during anesthesia reduces the incidence of postoperative nausea and vomiting. Anesthesiology 85:1055–1062CrossRefPubMed
31.
Ebert TJ (1990) Differential effects of nitrous oxide on baroreflex control of heart rate and peripheral sympathetic nerve activity in humans. Anesthesiology 72:16–22PubMed
32.
Eger EI 2nd (1963) The effect of inspired concentration on the rate of rise of alveolar concentration. Anesthesiology 24:153–157
33.
Eger EI 2nd, Saidman LJ (1965) Hazards of nitrous oxide anesthesia in bowel obstruction and pneumothorax. Anesthesiology 26:61–66PubMed
34.
Eisele JH Jr, Milstein JM, Goetzman BW (1986) Pulmonary vascular responses to nitrous oxide in newborn lambs. Anesth Analg 65:62–64PubMed
35.
Epstein RM, Rackow H, Salanitre E, Wolf GL (1964) Influence of the concentration effect on the uptake of anesthetic mixtures: the second gas effect. Anesthesiology 25:364–371PubMed
36.
Erkola O (1994) Nitrous oxide: laparoscopic surgery, bowel function, and PONV. Acta Anaesthesiol Scand 38:767–768
37.
Fang F, Guo T-Z, Davies MF, Maze M (1997) Opiate receptors in the periaqueductal gray mediate analgesic effect of nitrous oxide in rats. Eur J Pharmacol 336:137–141CrossRefPubMed
38.
Fauroux B, Onody P, Gall O, Tourniaire B, Koscielny S, Clement A (2004) The efficacy of premixed nitrous oxide and oxygen for fiberoptic bronchoscopy in pediatric patients: a randomised, double-blind controlled study. Chest 125:13–14CrossRefPubMed
39.
Felts JA, Poler SM, Spitznagel EL (1990) Nitrous oxide, nausea, and vomiting after outpatient gynaecologic surgery. J Clin Anesth 2:168–171CrossRefPubMed
40.
Field LM, Dorrance DE, Krzeminska KE, Barsoum LZ (1993) Effect of nitrous oxide on cerebral blood flow in normal humans. Br J Anesth 70:154–159
41.
Finck DA, Samaniego E, Ngai SH (1995) Nitrous oxide selectively releases met5-enkephalin and met5-enkephalin-arg6-phe7 into canine third ventricular cerebrospinal fluid. Anesth Analg 80:664–670CrossRefPubMed
42.
Fleisher LA, Nelson AK, Rosenbaum SH (1995) Post-operative myocardial ischemia: etiology of cardiac morbidity or manifestation of underlying disease? J Clin Anesth 7:97–102CrossRefPubMed
43.
Flippo TS, Holder WD (1993) Neurologic degeneration associated with nitrous oxide anesthesia in patients with vitamin B12 deficiency. Arch Surg 128:1391–1395PubMed
44.
Foschi D, Rizzi A, Zighetti ML et al. (2001) Effects of surgical stress and nitrous oxide anaesthesia on peri-operative plasma levels of total homocysteine. Anaesthesia 56:670–689CrossRefPubMed
45.
Freund FG, Martin WE, Wong KC, Horbein TF (1973) Abdominal muscle rigidity induced by morphine and nitrous oxide. Anesthesiology 38:358–362PubMed
46.
Fröhlich D, Rothe G, Wittmann S, Schmitz G, Schmid P, Taeger K, Hobbhahn J (1998) Nitrous oxide impairs the neutrophil oxidative response. Anesthesiology 88:1281–1290PubMed
47.
Fu AD, McDonald HR, Eliott D et al. (2002) Complications of general anesthesia using nitrous oxide in eye surgery with preexisting gas bubbles. Retina 22:569–574CrossRefPubMed
48.
Fujinaga M, Doone R, Davies MF, Maze M (2000) Nitrous oxide lacks the antinociceptive effect on the tail flick test in newborn rats. Anesth Analg 91:6–10CrossRefPubMed
49.
Giuffre M, Gross JB (1986) The effects of nitrous oxide on postoperative bowel motility. Anesthesiology 65:699–700PubMed
50.
Goerig M, Schulte am Esch J (2002) Frühe Beiträge zur Entwicklung der Lachgas-Sauerstoff-Anästhesie in Mitteleuropa. Anaesthesiol Reanimat 27:42–53
51.
Goldman LJ (2003) Anesthetic uptake of sevoflurane and nitrous oxide during an inhaled induction in children. Anesth Analg 96:400–406CrossRefPubMed
52.
Graham IM, Daly LE, Refsum H et al. (1997) Plasma homocysteine as a risk factor for vascular disease: the European Concerted Action Project. JAMA 277:1775–1781CrossRefPubMed
53.
Gruss M, Bushell JT, Bright DP, Lieb WR, Mathie A, Franks PN (2004) Two-pore-domain K+ channels are a novel target for the anesthetic gases xenon, nitrous oxide, and cyclopropane. Mol Pharmacol 65:443–452CrossRefPubMed
54.
Guo T-Z, Poree L, Golden W, Stein J, Fujinaga M, Maze M (1996) Antinociceptive response to nitrous oxide is mediated by supraspinal opiate and spinal α2 adrenergic receptors in the rat. Anesthesiology 85:846–852CrossRefPubMed
55.
Guo T-Z, Davies MF, Kingery WS, Patterson AJ, Limbird LE, Maze M (1999) Nitrous oxide produces antinociceptive response via α2B and/or α2C adrenoceptor subtypes in mice. Anesthesiology 90:470–476CrossRefPubMed
56.
Guttormsen AB, Refsum H, Ueland PM (1994) The interaction between nitrous oxide and cobalamin. Biochemical effects and clinical consequences. Acta Anaesthesiol Scand 38:753–756
57.
Hackam DG, Peterson JC, Spence JD (2000) What level of plasma homocyst(e)ine should be treated? Effects of vitamin therapy on progression of carotid atherosclerosis in patients with homocyst(e)ine levels above 14 µmol/L. Am J Hypertens 13:105–108CrossRefPubMed
58.
Hadzic A, Krysztof G, Sanborn KV, Thys DM (1995) Severe neurologic deficit after nitrous oxide anesthesia. Anesthesiology 83:863–866PubMed
59.
60.
Hapfelmeier G, Zieglgänsberger W, Haseneder R, Schneck H, Kochs E (2000) Nitrous oxide and xenon increase the efficacy of GABA at recombinant mammalian GABA(A) receptors. Anesth Analg 91:1542–1549PubMed
61.
Harmon D, Rozario C, Lowe D (2003) Nitrous oxide/oxygen mixture and the prevention of pain during injection of propofol. Eur J Anaesthesiol 20:158–161PubMed
62.
Hashimoto T, Maze M, Ohashi Y, Fujinaga M (2001) Nitrous oxide activates GABAergic neurons in the spinal cord in fischer rats. Anesthesiology 95:463–469CrossRefPubMed
63.
64.
Hee HI, Goy RW, As NG (2003) Effective reduction of anxiety and pain during venous cannulation in children: a comparison of analgesic efficacy conferred by nitrous oxide, EMLA and combination. Paediatr Anaesth 13:210–216PubMed
65.
Hellenthal A, Lauven PM (2001) Klinische Pharmakologie von Stickoxydul. Anaesthesiol Intensivmed Notfallmed Schmerzther 36:642–644CrossRef
66.
Hemelrijck J van, Smith I, White PF (1991) Use of desflurane for outpatient anesthesia. Anesthesiology 75:197–203PubMed
67.
Hendrickx JFA, Coddens J, Callebaut F, Artico H, Deloof T, Demeyer I, De Wolf MA (2002) Effect of N2O on sevoflurane vaporizer settings during minimal- and low-flow anesthesia. Anesthesiology 97:400–404CrossRefPubMed
68.
Henriksen HT, Jørgensen PB (1973) The effect of nitrous oxide on intracranial pressure in patients with intracranial disorders. Br J Anaesth 45:486–492PubMed
69.
Herbert MK, Raile S (2001) Brauchen wir noch Lachgas?. Anaesthesiol Intensivmed Notfallmed Schmerzther 36:380–381CrossRef
70.
Hermann L (1866) Notiz ueber die Empfehlung des Stickoxyduls als Anaestheticum. Bln Klein Wochenschr 3:115–116
71.
Hobbhahn J (2001) Toxizität von Stickoxydul. Anaesthesiol Intensivmed Notfallmed Schmerzther 36:641–642CrossRef
72.
Hodges BL, Gagnon MJ, Gillespie TR, Breneisen JR, O’Leary DF, Hara S, Quock RM (1994) Antagonism of nitrous oxide antinociception in the rat hot plate test by site-specific mu and epsilon opioid receptor blockage. J Pharmacol Exp Ther 269:596–600
73.
Hohner P, Reiz S (1994) Nitrous oxide and the cardiovascular system. Acta Anaesthesiol Scand 38:763–766
74.
Jensen AG, Prevedoros H, Kullman E, Anderberg B, Lennmarken C (1993) Perioperative nitrous oxide does not influence recovery after laparoscopic cholecystectomy. Acta Anaesthesiol Scand 37:683–686PubMed
75.
Jenstrup M, Fruergaard KO, Mortensen CR (1999) Pollution with nitrous oxide using laryngeal mask or face mask. Acta Anaesthesiol Scand 43:663–666CrossRefPubMed
76.
Jevtovic-Todorovic V, Todorovic SM, Mennerick S et al. (1998) Nitrous oxide (laughing gas) is an NMDA antagonist, neuroprotectant and neurotoxin. Nat Med 4:40–464
77.
Jevtovic-Todorovic V, Beals J, Benshoff N, Olney JW (2003) Prolonged exposure to inhalational anesthetic nitrous oxide kills neurons in adult rat brain. Neuroscience 122:609–616CrossRefPubMed
78.
Kingery WS, Sawamura S, Agashe GS, Davies MF, Clark JD, Zimmer A (2001) Enkephalin release and opioid receptor activation does not mediate the antinociceptive or sedative/hypnotic effects of nitrous oxide. Eur J Pharmacol 427:27–35CrossRefPubMed
79.
Klikowitsch S (1881) Ueber das Stickstoffoxydul als Anaestheticum bei Geburten. Arch Gynaekol 18:81–108
80.
Knill-Jones RP, Rodrigues LV, Moir DD, Spence AA (1972) Anaesthetic practice and pregnancy: controlled survey of women anaesthetists in the United Kingdom. Lancet 1:1326–1328CrossRefPubMed
81.
Koblin DD, Waskel L, Watson JE (1982) Nitrous oxide inactivates methionine synthase in human liver. Anesth Analg 61:75–78PubMed
82.
Kondo H, Osborne ML, Kolhouse JF et al. (1981) Nitrous oxide has multiple deleterious effects on cobalamin metabolism and causes decreases in activities of both mammalian cobalamin-dependant enzymes in rats. J Clin Invest 67:1270–1283PubMed
83.
Korman B, Mapleson WW (1997) Concentration and second gas effects: can the accepted explanation be improved? Br J Anaesth 78:618–625PubMed
84.
Krogh B, Jensen J, Henneberg SW, Hole P, Kronborg O (1994) Nitrous oxide does not influence operating conditions or postoperative course in colonic surgery. Br J Anaesth 72:55–57
85.
Kugel G, Letelier C, Zive MA, King JC (1990) Nitrous oxide and infertility. Anesth Prog 37:176–180PubMed
86.
Lahoud GY, Averley PA (2002) Comparison of sevoflurane and nitrous oxide mixture with nitrous oxide alone for inhalation conscious sedation in children having dental treatment: a randomised controlled trial. Anaesthesia 57:446–450CrossRefPubMed
87.
Landon MJ, Creagh-Barry P, McArthur S, Charlett A (1992) Influence of vitamin B12 status on the inactivation of methionine synthase by nitrous oxide. Br J Anaesth 69:81–86PubMed
88.
Landsberg G, Luria MH, Cotev S et al. (1993) Importance of long duration ST-segment depression in cardiac morbidity after vascular surgery. Lancet 341:715–719CrossRefPubMed
89.
Langbein T, Sonntag H, Trapp D et al. (1999) Volatile anaesthetics and the atmosphere: atmospheric effects of halothane, enflurane, isoflurane, desflurane and sevoflurane. Br J Anaesth 82:66–73PubMed
90.
Larsen R (2001) Inhalationsanästhesie. In: Larsen R (Hrsg) Anästhesie. Urban & Fischer, München, Jena, S 22
91.
Lassen HCA, Henriksen E, Neukirch F, Kristensen H (1956) Treatment of tetanus. Severe bone-marrow depression after prolonged nitrous oxide anaesthesia. Lancet 1:527–530CrossRef
92.
Layzer RB (1978) Myeloneuropathy after prolonged exposure to nitrous oxide. Lancet 2:1227–1230CrossRefPubMed
93.
Lebenbom-Mansour MH, Pandit SK, Kothary SP, Randel GI, Levy L (1993) Desflurane versus propofol anesthesia: a comparative analysis in outpatients. Anesth Analg 76:936–941PubMed
94.
Li SH, Li SN, Shih HY, Yi HD, Chiang CY (2002) Personnel exposure to waste sevoflurane and nitrous oxide during general anesthesia with cuffed endotracheal tube. Acta Anaesthesiol Sin 40:185–190PubMed
95.
Logan M, Farmer JG (1989) Anaesthesia and the ozone layer. Br J Anaesth 63:654–647
96.
Lunn JK, Stanley TH, Eisele J (1979) High-dose fentanyl anesthesia for coronary artery surgery: plasma fentanyl concentrations and influence of nitrous oxide on cardiovascular responses. Anesth Analg 58:390–395PubMed
97.
Ma D, Wilhelm S, Maze M, Franks NP (2002) Neuroprotective and neurotoxic properties of the „inert“ gas, xenon. Br J Anaesth 89:739–746CrossRefPubMed
98.
Mapleson WW, Korman B (1998) Concentration and second-gas effects in the water analogue. Br J Anaesth 81:837–843PubMed
99.
Marx T (1997) Belastung des Arbeitsplatzes mit volatilen Anästhetika und Lachgas. Anaesthesiol Intensivmed Notfallmed Schmerzther 32:532–540
100.
Masood J, Shah N, Lane T, Andrews H, Simpson P, Barua JM (2002) Nitrous oxide (Entonox) inhalation and tolerance of transrectal ultrasound guided prostate biopsy: a double-blind randomised controlled study. J Urol 168:116–120
101.
Mayer EL, Jakobsen DW, Robinson K (1996) Homocysteine and coronary atherosclerosis. J Am Coll Cardiol 27:517–527CrossRefPubMed
102.
Maze M, Fujinaga M (2000) Recent advances in understanding the actions and toxicity of nitrous oxide. Anaesthesia 55:311–314CrossRefPubMed
103.
McGlothlin JD, Jensen PA, Todd WF, Fischbach TJ (1988) Study protocol: control of anesthetic gases in dental opertories. Cincinnati: National Institute for Occupational Safety and Health
104.
Mennerick S, Jevtovic-Todorovic V, Todorovic SM, Shen W, Olney JW, Zorumski CF (1998) Effect of nitrous oxide on excitatory and inhibitory synaptic transmission in hippocampal cultures. J Neurosci 18:9716–9726PubMed
105.
Meretoja OA, Takkunen O, Heikkilä H, Wegelius U (1985) Hemodynamic response to nitrous oxide during high-dose fentanyl pancuronium anaesthesia. Acta Anaesthesiol Scand 29:137–141PubMed
106.
Milocco I, Schlossman D, William-Olsson G, Appelgren LK (1985) Fentanyl-droperidol-nitrous oxide anaesthesia in patients with ischemic heart disease and various degrees of left ventricular functional impairment. Acta Anaesthesiol Scand 29:683–692PubMed
107.
Moudgil GC, Gordon J, Forrest JB (1984) Comparative effects of volatile anaesthetic agents and nitrous oxide on human leukocyte migration in vitro. Can Anaesth Soc J 31:631–637PubMed
108.
Muir JJ, Warner MA, Offord KP, Buck CF, Harper JV, Kunkel SE (1987) Role of nitrous oxide and other factors in postoperative nausea and vomiting: a randomised and blinded prospective study. Anesthesiology 66:513–518PubMed
109.
Murakawa M, Adachi T, Nakao S, Seo N, Shingu K, Mori K (1994) Activation of the cortical and medullary dopaminergic systems by nitrous oxide in rats: a possible neurochemical basis for psychotropic effects and postanesthetic nausea and vomiting. Anesth Analg 78:376–381
110.
Nagata A, Nakao S, Nishizawa N, Masuzawa M, Inada T, Murao K, Miyamoto E, Shingu K (2001) Xenon inhibits but N(2)O enhances ketamine-induced c-Fos expression in the rat posterior cingulated and retrosplenial cortices. Anesth Analg 92:362–368CrossRefPubMed
111.
Nakayama H, Takahashi H, Okubo N, Miyabe M, Toyooka H (2002) Xenon and nitrous oxide do not depress cardiac function in an isolated rat heart model. Can J Anaesth 49:375–379PubMed
112.
Nishikawa K, Kunimoto F, Isa Y, Miyoshi S, Takahashi K, Morita T, Arii H, Goto F (2000) Second gas effect of N2O on oxygen uptake. Can J Anaesth 47:506–510PubMed
113.
Nunn JF (1987) Clinical aspects of the interaction between nitrous oxide and vitamin B12. Br J Anaesth 59:3–13PubMed
114.
Nunn JF, O’Morain C (1982) Nitrous oxide decreases motility of human neutrophils in vitro. Anesthesiology 56:45–48PubMed
115.
Nygard O, Nordrehaug JE, Refsum H et al. (1997) Plasma homocysteine levels and mortality in patients with coronary artery disease. N Engl J Med 337:230–236CrossRefPubMed
116.
Olney JW, Labruyere J, Price MT (1989) Pathological changes induced in cerebrocortical neurones by phencyclidine and related drugs. Science 244:1360–1362PubMed
117.
Olney JW, Labruyere J, Wang G (1991) NMDA antagonist neurotoxicity: mechanism and prevention. Science 254:1515–1518PubMed
118.
O’Shea, Moultrie S, Drummond GB (2001) Influence of nitrous oxide on induction of anaesthesia with sevoflurane. Br J Anaesth 87:286–288CrossRefPubMed
119.
Pac-Soo CK, Wang C, Chakrabarti MK, Whitwam JG (2000) Comparison of the effects of inhalational anaesthetic agents on sympathetic activity in rabbits. Eur J Anaesthesiol 17:311–318CrossRefPubMed
120.
Parbrook GD, Kennedy BR (1964) Values of pre-mixed nitrous oxide and oxygen mixtures in relief of post-operative pain. BMJ 2:1303
121.
Paut O, Calméjane C, Delorme J, Lacroix F, Camboulives J (2001) EMLA versus nitrous oxide for venous cannulation in children. Anesth Analg 93:590–593CrossRefPubMed
122.
Pedersen FM, Wilken-Jensen C, Knudsen F, Lindekaer AL, Svare E (1993) The influence of nitrous oxide on recovery of bowel function after abdominal hysterectomy. Acta Anaesthesiol Scand 37:692–696PubMed
123.
Pelligrino DA, Miletich DJ, Hoffman WE, Albrecht RF (1984) Nitrous oxide markedly increases cerebral cortical metabolic rate and blood flow in the goat. Anesthesiology 60:405–412PubMed
124.
Perreault L, Normandin N, Plamondon L (1982) Middle ear pressure variations during nitrous oxide anaesthesia. Can Anaesth Soc J 29:428–434PubMed
125.
Pypendop BH, Ilkiw JE, Imai A, Bolich JA (2003) Hemodynamic effects of nitrous oxide in isoflurane-anesthetized cats. Am J Vet Res 64:273–278PubMed
126.
Quock RM, Graczak LM (1988) Influence of narcotic drugs upon nitrous oxide analgesia in mice. Brain Res 440:35–41CrossRefPubMed
127.
Quock RM, Curtis BA, Reynolds BJ, Mueller JL (1993) Dose-dependent antagonism and potentiation of nitrous oxide antinociception by naloxone in mice. J Pharmacol Exp Ther 267:117–122PubMed
128.
Rampil IJ, Kim JS, Lenhardt R, Negishi C, Sessler DI (1998) Bispectral EEG index during nitrous oxide administration. Anesthesiology 89:671–677CrossRefPubMed
129.
Reinstrup P, Messeter K (1994) Cerebrovascular response to nitrous oxide. Acta Anaesthesiol Scand 38:761–762
130.
Reinstrup P, Ryding E, Algotsson L, Berntman L, Uski T (1994) Effects of nitrous oxide on human regional cerebral blood flow and isolated pial arteries. Anesthesiology 81:396–402PubMed
131.
Reinstrup P, Ryding E, Ohlsson T, Dahm PL, Uski T (2001) Cerebral blood volume (cbv) in humans during normo- and hypocapnia; influence of nitrous oxide (N2O). Anesthesiology 95:1079–1082CrossRefPubMed
132.
Rowland AS, Baird DD, Weinberg CA, Shore DL, Shy CM, Wilcox AJ (1992) Reduced fertility among women employed as dental assistants exposed to high levels of nitrous oxide. N Engl J Med 327:993–997PubMed
133.
Rupreht J, Dworacek B, Bonke B, Dzoljic MR, Eijndhoven MR van, Vlieger M de (1985) Tolerance to nitrous oxide in volunteers. Acta Anaesthesiol Scand 29:635–638PubMed
134.
Russell GB, Snider MT, Richard RB, Loomis JL (1990) Hyperbaric nitrous oxide as a sole anesthetic agent in humans. Anesth Analg 70:289–295PubMed
135.
Salanitre E, Rackow H (1976) N2O volumes absorbed and excreted during N2O anesthesia in children. Anesth Analg 55:95–99PubMed
136.
Sarner JB, Levine M, Davis PJ, Lerman J, Cook DR, Motoyama EK (1995) Clinical characteristics of sevoflurane in children; a comparison with halothane. Anesthesiology 82:38–46CrossRefPubMed
137.
Sawamura S, Kingery WS, Davies MF et al. (2000) Antinociceptive action of nitrous oxide is mediated by stimulation of noradrenergic neurons in the brainstem and activation of α2B adrenoceptors. J Neurosci 20:9242–9251PubMed
138.
Scheinin B, Lindgren L, Scheinin TM (1990) Perioperative nitrous oxide delays bowel function after colonic surgery. Br J Anaesth 64:154–158PubMed
139.
140.
Schulte-Sasse U, Hess W, Tarnow J (1982) Pulmonary vascular responses to nitrous oxide in patients with normal and high pulmonary vascular resistance. Anesthesiology 57:9–13PubMed
141.
Sellgren J, Pontén J, Wallin BG (1990) Percutaneus recordings of muscle nerve sympathetic activity during propofol, nitrous oxide and isoflurane anesthesia in humans. Anesthesiology 73:20–27PubMed
142.
Sherman SJ, Cullen BF (1999) Nitrous oxide and the greenhouse effect. Anesthesiology 68:817
143.
Shiga T, Wajima Z, Inoue T, Ogawa R (2003) Nitrous oxide produces minimal hemodynamic changes in patients receiving a propofol-based anesthetic: an esophageal Doppler ultrasound study. Can J Anaesth 50:649–652PubMed
144.
Splinter WM, Roberts DJ, Rgine EJ, MacNeill HB, Komocar L (1995) Nitrous oxide does not increase vomiting in children after myringotomy. Can J Anaesth 42:274–276PubMed
145.
Stamler JS, Osborne JA, Jaraki O, Rabbani LE, Mullins M, Singel D, Loscalzo J (1993) Adverse vascular effects of homocysteine are modulated by endothelium-derived relaxing factor and related oxides of nitrogen. J Clin Invest 91:308–318PubMed
146.
Stenqvist O, Husum B, Dale O (2001) Nitrous oxide: an ageing gentleman. Acta Anaesthesiol Scand 45:135–137CrossRefPubMed
147.
Stoelting RK, Eger EI 2nd (1969) An additional explanation for the second gas effect: a concentrating effect. Anesthesiology 30:273–277PubMed
148.
Stubbs PJ, Al-Obaidi MK, Conroy RM, Collinson PO, Graham IM, Noble MI (2000) Effect of plasma homocysteine concentration on early and late events in patients with acute coronary syndromes. Circulation 102:605–610PubMed
149.
Sun X-G, Su F, Shi YQ, Lee C (1999) The „second gas effect“ is not a valid concept. Anesth Analg 88:188–192CrossRefPubMed
150.
Swan HD, Crawford MW, Pua HL, Stephens D, Lerman J (1999) Additive contribution of nitrous oxide to sevoflurane minimum alveolar concentration for tracheal intubation in children. Anesthesiology 91:667–671CrossRefPubMed
151.
Taheri S, Eger EI 2nd (1999) A demonstration of the concentration and second gas effects in humans anesthetized with nitrous oxide and desflurane. Anesth Analg 89:774–780CrossRefPubMed
152.
Takàcs J (1996) N2O-induzierte akute funikuläre Myelose bei latentem Vitamin B12-Mangel. Anaesthesiol Intensivmed Notfallmed Schmerzther 31:525–528
153.
Taylor E, Feinstein R, White PF, Soper N (1992) Anesthesia for laparoscopic cholecystectomy. Anesthesiology 76:541–543PubMed
154.
Thomson IA, Hughes RL, Fitch W, Campbell D (1982) Effects of nitrous oxide on liver haemodynamics and oxygen consumption in the greyhound. Anaesthesia 37:548–553PubMed
155.
Todorovic SM, Jevtovic-Todorovic V, Mennerick S, Perez-Reyes E, Zorumski CF (2001) Cav3.2 channel is a molecular substrate for inhibition of T-type calcium currents in rat sensory neurons by nitrous oxide. Mol Pharmacol 60:603–610PubMed
156.
Todorovic SM, Jevtovic-Todorovic V, Meyenburg A et al. (2001) Redox modulation of T-type calcium channels in rat peripheral nociceptors. Neuron 31:75–85CrossRefPubMed
157.
Tramer M, Moore A, McQuay H (1996) Omitting nitrous oxide in general anaesthesia: meta-analysis of intraoperative awareness and postoperative emesis in randomised controlled trials. Br J Anaesth 76:186–193PubMed
158.
159.
Tunstall ME, Hawksworth GM (1981) Halothane uptake and nitrous oxide concentration: arterial halothane levels during caesarian section. Anesthesia 36:177–182
160.
Vaisman AI (1967) Working conditions in the operating room and their effect on the health of anesthetists. Eksp Khir Anestheziol 12:44–49
161.
Vessey MP (1978) Epidemiological studies of the occupational hazards of anaesthesia—a review. Anaesthesia 33:430–438PubMed
162.
Vieira E, Cleaton-Jones P, Moyes D (1983) Effects of low intermittent concentrations of nitrous oxide on the developing rat fetus. Br J Anaesth 55:67–69PubMed
163.
Vollmar B, Conzen P, Habazettl H, Adili F, Peter K (1995) Does nitrous oxide affect coronary microcirculation? An intravital microscopic study in the canine heart. Anesth Analg 80:249–255CrossRefPubMed
164.
Watanabe S, Asakura N, Taguchi N (1993) Supramaximal second gas effect: more rapid rise of alveolar halothane concentration during ipsilateral lung N2O administration compared to bilateral administration. Anesth Analg 76:69–76PubMed
165.
Watcha MF, Simeon RM, White PF, Stevens JL (1991) Effect of propofol on the incidence of postoperative vomiting after strabismus surgery in pediatric outpatients. Anesthesiology 75:204–209PubMed
166.
167.
Welch WD (1984) Effect of enflurane, isoflurane, and nitrous oxide on the microbicidal activity of human polymorphonuclear leukocytes. Anesthesiology 61:188–192PubMed
168.
Whitcher CE, Zimmermann DC, Tonn EM, Piziali RL (1977) Control of occupational exposure to nitrous oxide in the dental operatory. J Am Dent Assoc 95:736–776
169.
Wilson IG, Fell D (1993) Nitrous oxide and postoperative vomiting in children undergoing myringotomy as a day case. Paediatr Anaesth 3:283–285
170.
Wrigley SR, Fairfield JE, Jones RM, Black AE (1991) Induction and recovery characteristics of desflurane in day case patients: a comparison with propofol. Anaesthesia 46:615–622PubMed
171.
Wynne J, Mann T, Alpert S (1980) Hemodynamic effects of nitrous oxide administered during cardiac catheterisation. JAMA 243:1440–1442CrossRefPubMed
172.
Yacoub O, Doell D, Kryger MH, Anthonisen NR (1975) Depression of hypoxic ventilatory response by nitrous oxide. Anesthesiology 45:385–389
173.
Yang JC, Clark WC, Ngai SH (1980) Antagonism of nitrous oxide analgesia by naloxone in man. Anesthesiology 52:414–417PubMed
174.
Yang YF, Herbert L, Rüschen H, Cooling RJ (2002) Nitrous oxide anaesthesia in the presence of intraocular gas can cause irreversible blindness. BMJ 325:532–533CrossRefPubMed
175.
Yoo KY, Jeong ST, Ha IH, Lee J (2003) Nitrous oxide attenuates pressor but augments norepinephrine response to laryngoscopy and endotracheal intubation. Anesth Analg 96:1516–1521PubMed
176.
Zacny JP, Hurst RJ, Graham L, Janiszewski DJ (2002) Preoperative dental anxiety and mood changes during nitrous oxide inhalation. J Am Dent Assoc 133:82–88PubMed
177.
Zhang C, Davies MF, Guo T-Z, Maze M (1999) The analgesic action of nitrous oxide is dependent on the release of norepinephrine in the dorsal horn of the spinal cord. Anesthesiology 9:1401–1407CrossRef
178.
Zuniga J, Joseph S, Knigge K (1987) Nitrous oxide analgesia: partial antagonism by naloxone and total reversal after periaqueductal gray lesions in the rat. Eur J Pharmacol 142:51–60CrossRefPubMed
179.
Zwass MS, Fisher DM, Welborn LG et al. (1992) Induction and maintenance characteristics of anesthesia with desflurane and nitrous oxide in infants and children. Anesthesiology 76:373–378PubMed
Metadaten
Titel
Lachgas
Sinn oder Unsinn für die heutige Narkoseführung
verfasst von
M. E. Schönherr
PD Dr. med. Dr. rer. nat. M. W. Hollmann
B. Graf
Publikationsdatum
01.09.2004
Verlag
Springer-Verlag
Erschienen in
Die Anaesthesiologie / Ausgabe 9/2004
Print ISSN: 2731-6858
Elektronische ISSN: 2731-6866
DOI
https://doi.org/10.1007/s00101-004-0742-9

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