A 74-year-old woman with a history of a previous total abdominal hysterectomy presents with abdominal pain and distention for 3 days. She is noted on plain films to have dilated small-bowel and air-fluid levels. She is taken to the operating room for a small-bowel obstruction. Which of the following inhalational anesthetics should be avoided because of accumulation in air-filled cavities during general anesthesia?
Nitrous oxide has a low solubility compared with other inhalation anesthetics; nitrous oxide is more soluble in blood than nitrogen and is the only anesthetic gas less dense than air. As a result of these propeies, nitrous oxide may cause progressive distension of air-filled spaces during prolonged anesthesia. Since nitrous oxide diffuses into gas-filled compaments faster than nitrogen can diffuse out, its use can lead to worsened distention, which may be undesirable (eg, in an operation for intestinal obstruction).
Diethyl ether
Nitrous oxide
Halothane
Methoxyflurane
Miscellaneous