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Review Question - QID 527

QID 527 (Type "527" in App Search)
Nitrous oxide has which of the following important effects when used during orthopedic procedures?

Potential interaction with oral contrast material

1%

36/2910

Slow induction times

15%

441/2910

Interferes with self-passivation of titanium implants

13%

376/2910

Gaseous abdominal distension

57%

1669/2910

Increases risk of metal ion release from stainless steel implants

13%

371/2910

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Nitrous oxide is used as an induction agent during anesthesia. Unfortunately, the nitrous oxide is released by the blood into the bowel and is unable to return back to the blood in similar quantities. This gaseous distension is important during procedures where fluoroscopy of the abdomen is needed, i.e. pelvic and spinal surgery.

The referenced article by Starr et al notes the difficulty of percutaneous pelvic surgery with use of this induction agent and recommends against its use during these procedures. This article also notes that percutaneous reduction and fixation of posterior pelvic ring injuries is safe and has a high level of patient reported satisfaction levels.

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