Lesson of the week: Nitrous oxide anaesthesia in the presence of intraocular gas can cause irreversible blindness

Yang, Yingjia; Herbert, Luke; Rüschen, Heinrich; Cooling, R J

doi:10.1136/bmj.325.7363.532

Cited by 36 publications

(11 citation statements)

References 9 publications

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“…Nitrous oxide should not be used in patients with intravitreal gas. The great importance of this is emphasized by another recently published case report similar to ours (6).…”

Section: Discussionsupporting

confidence: 75%

Nitrous oxide anesthesia and intravitreal gastamponade

Åström¹,

Kjellgren²,

Mönestam³

et al. 2003

Acta Anaesthesiol Scand

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The right eye of a 66-year-old man was operated with vitrectomy and peeling of an epiretinal membrane. Perioperatively, the eye was filled with 20% SF6 gas to tamponade retinal breaks. Five days later the patient underwent prostatectomy under general anesthesia using nitrous oxide. Postoperatively the eye had no light perception as a result of ischemic retinopathy. The movement of nitrous oxide into gas-containing spaces in the body has been known for a long time. The use of nitrous oxide in patients with intravitreal gas will elevate the intraocular pressure with risk for closure of the central retinal artery. The present case report highlights the problems that can occur when preoperative assessment is carried out a long time before surgery.

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“…Nitrous oxide should not be used in patients with intravitreal gas. The great importance of this is emphasized by another recently published case report similar to ours (6).…”

Section: Discussionsupporting

confidence: 75%

Nitrous oxide anesthesia and intravitreal gastamponade

Åström¹,

Kjellgren²,

Mönestam³

et al. 2003

Acta Anaesthesiol Scand

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show abstract

“…intramuscular administration), which increases IOP. After procedures in which intravitreal gases, for example, SF6 or perfluorocarbon, are used, nitrous oxide should not be administered because it can diffuse into closed spaces, expand and interact with the intravitreal gas to markedly increase IOP (Yang et al. 2002; Åström et al.…”

Section: Clinical Findings and Diagnosticsmentioning

confidence: 99%

The Glaucoma Guidelines of the Swedish Ophthalmological Society

Heijl

Alm²,

Bengtsson³

et al. 2012

Acta Ophthalmologica

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“…A patient10 underwent uncomplicated left pars plana vitrectomy with intraocular gas (C 3 F 8 14%) for RRD repair and was discharged from hospital the next day. Later that evening, he developed urinary retention, and attended a local NHS Emergency Medicine department.…”

Section: Resultsmentioning

confidence: 99%