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On Nitrous Oxide

Arch Surg. 1978;113(6):778. doi:10.1001/archsurg.1978.01370180120030.
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Malfunction of any nitrous oxide, or nitrous oxide/oxygen, delivery system can lead to harm or death of the patient. The magnitude of the problem is not known, since reporting in the medical literature is spotty at best, and reporting in the lay press is attended by much fanfare. Nevertheless, there exists a problem and it would appear reasonable to question whether nitrous oxide has so much to offer that such deaths as will occur can be accepted as a "justifiable overhead."

Technically, nitrous oxide is not an anesthetic agent but rather an analgesic; were one to opt for a purist approach, he would be hard pressed in justifying the use of a "nonanesthetic" agent where the primary objective is a condition of "anesthesia." Pragmatically, the physical properties of nitrous oxide are such that significant physiologic disturbances may occur at the time its administration is discontinued ("diffusion hypoxia"), while at the


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