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Year : 2018  |  Volume : 8  |  Issue : 2  |  Page : 54-56

Safer employment of nitrous oxide in anesthesia machines—a technical simulation

1 Department of Anesthesiology, Privatklinik Hochrum, Sanatorium der Kreuzschwestern, Rum, Austria
2 Department of Anesthesiology and Intensive Care Medicine, Hospitaller Brothers Hospital Salzburg, Paracelsus Medical University, Salzburg, Austria
3 Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany
4 Department of Anesthesiology, Intensive Care Medicine, Emergency Medicine and Pain Therapy, Friedrichshafen, Germany

Correspondence Address:
Holger Herff
Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne
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Source of Support: This study was supported by institutional resources only., Conflict of Interest: None

DOI: 10.4103/2045-9912.235127

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Several incidents of anesthesia-attributed mortality in the past were caused by misconnection of gas pipelines resulting in ventilation with pure nitrous oxide. A simple safety feature may be to “mark” nitrous oxide with a lower pressure than oxygen and room air within the hospital’s gas pipeline system. Then, any misconnection of gas pipelines could be detected by pressure differences with a manometer in the anesthesia machine. To check technical suitability, we tested maximum achievable nitrous oxide flows of an anesthesia machine at different pressures in the nitrous oxide supply line. Using decreased pressures for nitrous oxide compared to oxygen did not result in decreased nitrous oxide flows, as long as pressure in the nitrous oxide supply line was >1500 hPa. A concept of different pressures for nitrous oxide and oxygen could be used to technically differentiate between those two gases, and to avoid potentially fatal misconnections.

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