European Society of Anaesthesiology Task Force on Nitrous Oxide: a narrative review of its role in clinical practice

Wolfgang Buhre; Nicola Disma; Jan Hendrickx; Stefan DeHert; Markus W. Hollmann; Ragnar Huhn; Jan Jakobsson; Peter Nagele; Philip Peyton; Laszlo Vutskits

doi:10.1016/j.bja.2019.01.023

European Society of Anaesthesiology Task Force on Nitrous Oxide: a narrative review of its role in clinical practice

Wolfgang Buhre, Nicola Disma, Jan Hendrickx, Stefan DeHert, Markus W. Hollmann^*, Ragnar Huhn, Jan Jakobsson, Peter Nagele, Philip Peyton, Laszlo Vutskits

^*Corresponding author for this work

Research output: Contribution to journal › (Systematic) Review article › peer-review

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 contra-indications 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.

Original language	English
Pages (from-to)	587-604
Number of pages	18
Journal	British Journal of Anaesthesia
Volume	122
Issue number	5
DOIs	https://doi.org/10.1016/j.bja.2019.01.023
Publication status	Published - May 2019

Keywords

anaesthesia
analgesia
dental pain
labour analgesia
major depression
nitrous oxide
pain
pharmaco-economics
RANDOMIZED CONTROLLED-TRIAL
SURGICAL SITE INFECTION
MINIMUM ALVEOLAR CONCENTRATION
INSPIRED OXYGEN FRACTION
LONG-TERM MORBIDITY
PROCEDURAL SEDATION
GENERAL-ANESTHESIA
ADVERSE EVENTS
DOUBLE-BLIND
POSTOPERATIVE NAUSEA

Access to Document

10.1016/j.bja.2019.01.023Licence: Free access - publisher

Cite this

@article{4344f07c5be44f6faf614176d9fe8922,

title = "European Society of Anaesthesiology Task Force on Nitrous Oxide: a narrative review of its role in clinical practice",

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 contra-indications 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.",

keywords = "anaesthesia, analgesia, dental pain, labour analgesia, major depression, nitrous oxide, pain, pharmaco-economics, RANDOMIZED CONTROLLED-TRIAL, SURGICAL SITE INFECTION, MINIMUM ALVEOLAR CONCENTRATION, INSPIRED OXYGEN FRACTION, LONG-TERM MORBIDITY, PROCEDURAL SEDATION, GENERAL-ANESTHESIA, ADVERSE EVENTS, DOUBLE-BLIND, POSTOPERATIVE NAUSEA",

author = "Wolfgang Buhre and Nicola Disma and Jan Hendrickx and Stefan DeHert and Hollmann, {Markus W.} and Ragnar Huhn and Jan Jakobsson and Peter Nagele and Philip Peyton and Laszlo Vutskits",

note = "Funding Information: MWH reports grants from CSL Behring, grants from Eurocept BV, grants from BBraun, grants from Echo Pharmaceuticals and grants from MSD. JJ has a consultant contract with Linde Healthcare related to PharmacoVigilance. PN reports company ownership (NitroBiomedical) and a pending patent for the use of N2O in major depressive disorder. Publisher Copyright: {\textcopyright} 2019 British Journal of Anaesthesia",

year = "2019",

month = may,

doi = "10.1016/j.bja.2019.01.023",

language = "English",

volume = "122",

pages = "587--604",

journal = "British Journal of Anaesthesia",

issn = "0007-0912",

publisher = "ELSEVIER SCI LTD",

number = "5",

}

TY - JOUR

T1 - European Society of Anaesthesiology Task Force on Nitrous Oxide

T2 - a narrative review of its role in clinical practice

AU - Buhre, Wolfgang

AU - Disma, Nicola

AU - Hendrickx, Jan

AU - DeHert, Stefan

AU - Hollmann, Markus W.

AU - Huhn, Ragnar

AU - Jakobsson, Jan

AU - Nagele, Peter

AU - Peyton, Philip

AU - Vutskits, Laszlo

N1 - Funding Information: MWH reports grants from CSL Behring, grants from Eurocept BV, grants from BBraun, grants from Echo Pharmaceuticals and grants from MSD. JJ has a consultant contract with Linde Healthcare related to PharmacoVigilance. PN reports company ownership (NitroBiomedical) and a pending patent for the use of N2O in major depressive disorder. Publisher Copyright: © 2019 British Journal of Anaesthesia

PY - 2019/5

Y1 - 2019/5

N2 - 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 contra-indications 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.

AB - 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 contra-indications 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.

KW - anaesthesia

KW - analgesia

KW - dental pain

KW - labour analgesia

KW - major depression

KW - nitrous oxide

KW - pain

KW - pharmaco-economics

KW - RANDOMIZED CONTROLLED-TRIAL

KW - SURGICAL SITE INFECTION

KW - MINIMUM ALVEOLAR CONCENTRATION

KW - INSPIRED OXYGEN FRACTION

KW - LONG-TERM MORBIDITY

KW - PROCEDURAL SEDATION

KW - GENERAL-ANESTHESIA

KW - ADVERSE EVENTS

KW - DOUBLE-BLIND

KW - POSTOPERATIVE NAUSEA

U2 - 10.1016/j.bja.2019.01.023

DO - 10.1016/j.bja.2019.01.023

M3 - (Systematic) Review article

SN - 0007-0912

VL - 122

SP - 587

EP - 604

JO - British Journal of Anaesthesia

JF - British Journal of Anaesthesia

IS - 5

ER -