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Special cases: ketamine, nitrous oxide and xenon.
Best Pract Res Clin Anaesthesiol. 2006 Mar; 20(1):69-79.BP

Abstract

Most general anaesthetic agents produce anaesthesia by increasing the activity of inhibitory gamma-aminobutyric acid type A receptors. The effects of ketamine, xenon and nitrous oxide on these receptors are, however, negligible. These anaesthetic agents potently inhibit excitatory N-methyl-D-aspartate receptors. Although these anaesthetic agents display some similar clinical features, such as potent analgesic effects, there are some important differences. Ketamine and nitrous oxide produce sympathomimetic effects, whereas xenon produces a sympatholytic effect. In addition, these anaesthetic agents return differential signals on clinical available anaesthetic depth monitors such as the bispectral index and mid-latency auditory evoked potential. Ketamine and nitrous oxide do not per se decrease the bispectral index. However, xenon decreases the bispectral index in a concentration-dependent manner. Similarly, ketamine and nitrous oxide do not suppress the mid-latency auditory evoked potential whereas xenon does. Thus, anaesthetic depth monitors fail to describe consciousness accurately when ketamine and nitrous oxide are used.

Authors+Show Affiliations

Department of Anesthesiology, University of Hirosaki School of Medicine, Hirosaki 036-8563, Japan. masuika@cc.hirosaki-u.ac.jp

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

16634415

Citation

Hirota, Kazuyoshi. "Special Cases: Ketamine, Nitrous Oxide and Xenon." Best Practice & Research. Clinical Anaesthesiology, vol. 20, no. 1, 2006, pp. 69-79.
Hirota K. Special cases: ketamine, nitrous oxide and xenon. Best Pract Res Clin Anaesthesiol. 2006;20(1):69-79.
Hirota, K. (2006). Special cases: ketamine, nitrous oxide and xenon. Best Practice & Research. Clinical Anaesthesiology, 20(1), 69-79.
Hirota K. Special Cases: Ketamine, Nitrous Oxide and Xenon. Best Pract Res Clin Anaesthesiol. 2006;20(1):69-79. PubMed PMID: 16634415.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Special cases: ketamine, nitrous oxide and xenon. A1 - Hirota,Kazuyoshi, PY - 2006/4/26/pubmed PY - 2006/6/7/medline PY - 2006/4/26/entrez SP - 69 EP - 79 JF - Best practice & research. Clinical anaesthesiology JO - Best Pract Res Clin Anaesthesiol VL - 20 IS - 1 N2 - Most general anaesthetic agents produce anaesthesia by increasing the activity of inhibitory gamma-aminobutyric acid type A receptors. The effects of ketamine, xenon and nitrous oxide on these receptors are, however, negligible. These anaesthetic agents potently inhibit excitatory N-methyl-D-aspartate receptors. Although these anaesthetic agents display some similar clinical features, such as potent analgesic effects, there are some important differences. Ketamine and nitrous oxide produce sympathomimetic effects, whereas xenon produces a sympatholytic effect. In addition, these anaesthetic agents return differential signals on clinical available anaesthetic depth monitors such as the bispectral index and mid-latency auditory evoked potential. Ketamine and nitrous oxide do not per se decrease the bispectral index. However, xenon decreases the bispectral index in a concentration-dependent manner. Similarly, ketamine and nitrous oxide do not suppress the mid-latency auditory evoked potential whereas xenon does. Thus, anaesthetic depth monitors fail to describe consciousness accurately when ketamine and nitrous oxide are used. SN - 1521-6896 UR - https://www.unboundmedicine.com/medline/citation/16634415/Special_cases:_ketamine_nitrous_oxide_and_xenon_ DB - PRIME DP - Unbound Medicine ER -