The effect of nitrous oxide inhalation on the hypotensive response to propofol: a randomized controlled trial

Oral Surg Oral Med Oral Pathol Oral Radiol. 2014 Aug;118(2):166-73. doi: 10.1016/j.oooo.2013.03.020. Epub 2013 Jun 4.

Abstract

Objective: Decrease in arterial blood pressure is a prominent adverse reaction during propofol (Disoprivan; AstraZeneca K.K., Osaka, Japan) sedation. The purpose of this prospective randomized study was to explore the effects of nitrous oxide (N2O) on the hypotensive response during propofol sedation.

Study design: Twenty-six healthy volunteers received intravenous sedation with propofol alone (group P, n=13) or a combined technique using 20% N2O and propofol (group N+P, n=13). Propofol was administered by a target-controlled infusion system to attain and maintain a plasma propofol concentration of 1.5μg/mL. Hemodynamic and autonomic parameters were measured.

Results: Mean arterial pressure decreased in both groups, the hypotensive response in group N+P being significantly smaller than in group P. Reduction in the low-frequency power of systolic blood pressure variability, indicative of sympathetic nervous activity, was also smaller in group N+P than in group P.

Conclusions: Addition of N2O to propofol sedation can attenuate the hypotensive effect of propofol.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Administration, Inhalation
  • Adult
  • Anesthetics, Inhalation / administration & dosage*
  • Anesthetics, Intravenous / administration & dosage
  • Blood Pressure / drug effects*
  • Female
  • Healthy Volunteers
  • Hemodynamics / drug effects
  • Humans
  • Hypotension / chemically induced*
  • Hypotension / prevention & control*
  • Japan
  • Male
  • Monitoring, Physiologic
  • Nitrous Oxide / administration & dosage*
  • Propofol / administration & dosage

Substances

  • Anesthetics, Inhalation
  • Anesthetics, Intravenous
  • Nitrous Oxide
  • Propofol