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Nitrous oxide use in neuroanesthesia is often employed to limit use of volatile<br />
agents to limit interference with neuromonitoring during surgery. However, its<br />
use is controversial. Which of the following statements regarding nitrous oxide<br />
use is INCORRECT?<br />
<br />
a) It can be discontinued before closure of the dura to decrease the possibility of<br />
developing post-operative tension pneumocephalus<br />
<br />
b) It can be continued to the end of the surgery to allow for a rapid awakening<br />
<br />
c) Its use should be monitored closely as it increases CMRO2, CBF, and ICP<br />
<br />
d) Its use should be discouraged completely because it has been shown to impair<br />
the developing brain of humans<br />
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==Answer==<br />
Answer d. Previous concerns for postoperative tension pneumocephalus with the<br />
use of nitrous oxide have been rebutted;39 N2O can safely be used for the entire<br />
surgery. A reasonable alternative is to discontinue its use just before closure of<br />
the dura. Because it increases CMRO2, CBF, and ICP,40,41,42 its use in conditions<br />
of decreased cerebral compliance should be closely monitored, especially if not<br />
counteracted by simultaneous hyperventilation.43 Nonetheless, some pediatric<br />
anesthesiologists avoid nitrous oxide altogether because of a concern for<br />
impairment in the developing brain of animals.44<br />
==Notes==<br />
<references /><br />
:This question originally printed in the [http://www.amazon.com/Justin-L.-Lockman/e/B00FLG5AEE/ref=ntt_dp_epwbk_0 Pediatric Anesthesiology Review Topics] kindle book series, and appears courtesy of Naerthwyn Press, LLC.<br />
==Keywords==<br />
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