Comparison of the sedative, cognitive, and analgesic effects of nitrous oxide, sevoflurane, and ethanol

British Journal of Anaesthesia
R DuarteB Tiplady

Abstract

Anaesthetics which work by different mechanisms may have different patterns of effect. Measurement of these patterns thus may elucidate their mechanisms of action and allow therapeutic choices between the agents. We compared the effects of ethanol (approximately 80 mg per 100 ml), and different end-tidal concentrations of nitrous oxide (15% and 25%) and sevoflurane (0.3% and 0.5%) in volunteers. We measured speed and accuracy in psychomotor tests, reaction time and memory, touch and pain sensitivity to von Frey filaments, and subjective mood for a range of descriptors. All treatments caused the same degree of overall abnormal feelings, but sevoflurane caused more obtunding (subjective drowsiness, slow reaction times, and loss of memory function) and nitrous oxide was more analgesic. Ethanol caused a marked feeling of drunkenness, but little drowsiness or analgesia. In the same volunteer subjects, direct comparison of sub-anaesthetic doses of these agents showed a clear and characteristic pattern of effects. These support the possible mechanisms for these disparate agents and may help choose appropriate agents for specific desired anaesthetic outcomes such as sedation or analgesia.

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Citations

Jul 15, 2009·British Journal of Anaesthesia·M CarronC Ori
Aug 31, 2012·British Journal of Anaesthesia·G B DrummondR R Kennedy
Dec 7, 2016·The Journal of Pain : Official Journal of the American Pain Society·Trevor ThompsonBrendon Stubbs
Sep 2, 2011·Journal of Anesthesia·Kalindi DeSousa, Mohamed Shaaban Ali
Sep 21, 2011·European Journal of Applied Physiology·Miroljub JakovljevićIgor B Mekjavic
Apr 17, 2012·Anesthesia and Analgesia·Gordon B DrummondR Ross Kennedy
Apr 22, 2015·Saudi Journal of Ophthalmology : Official Journal of the Saudi Ophthalmological Society·Hatem A Tawfik, Mohsen Mostafa
Mar 1, 2017·Academic Forensic Pathology·David Dolinak

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