Changes in CO-oximetry values and pulse oximetry in isoflurane-anesthetized dogs with and without nitrous oxide
2020
Jones, Teela | Feng, Cindy | Duke-Novakovski, Tanya
Concentrations of 64% to 70% nitrous oxide (N(2)O) provide intra-operative analgesia. Clinically, pulse oximeter estimation (SpO(2)) of oxygen (O(2)) hemoglobin saturation (SaO(2)) was observed to decrease with N2O. Absorption atelectasis from breathing O2 was thought to decrease arterial partial pressure of O2 (PaO(2)) below 70 mmHg and reduce SaO(2) and SpO(2) when N(2)O was used. Administering N(2)O from the beginning of the anesthesia might prevent atelectasis development and low PaO(2).The study was done in 2 parts (P, 0.05). In Part 1, isoflurane-anesthetized dogs undergoing ovariohysterectomy (n = 15 each group) breathed N(2)O from anesthesia start (N(2)O early) or 1 hour later (N2Olate). SpO(2), CO-oximetry values, and PaO(2) were compared to dogs breathing O(2) throughout anesthesia (control). Timing of N(2)O introduction did not affect PaO(2) (lowest = 94 mmHg), SaO(2), or SpO(2). With N(2)O, the lowest SpO(2) value was 91% and corresponded to a PaO2 of 151 mmHg. Carboxyhemoglobin increased (highest = 2.7%) and SaO(2) decreased with N2O (lowest = 96.7%). In Part 2, to replicate findings, 10 isoflurane-anesthetized dogs breathed N(2)O, then O(2). With N2O, SaO2 did not decrease, but carboxyhemoglobin increased and returned to baseline once N2O was discontinued. The dog with the highest carboxyhemoglobin (2%) had an SaO(2) of 96.8% (PaO(2) = 93 mmHg). Carboxyhemoglobin and SaO(2) changes were not clinically significant. Pulse oximetry did not reliably estimate SaO(2) but N(2)O was not always a factor.
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