What are the side effects?

Like any drug, anesthetic gases also have side effects. The most common side effects are postoperative nausea and vomiting. There can also be strong tremors and a feeling of cold after gas anesthesia.

One of the most feared complications after gas anaesthesia is malignant hypertension. This is a severe complication of anesthesia, which leads to muscle rigidity, tachycardia and increased temperature, due to a genetically predisposed skeletal muscle disease. Specific side effects:

Isoflurane: Isoflurane is one of the most effective anesthetic gases and is therefore used frequently.
However, it has a very pungent odor and can cause irritation of mucous membranes, so it should not be used for anesthetic induction. During anaesthesia isoflurane has rather positive side effects such as muscle relaxation and bronchodilatation.
Desflurane: Desfluran is also highly irritating to the mucous membranes and therefore cannot be used to induce anaesthesia. It can also lead to spasms of the larynx and bronchi.
Since Desfluran floods in and out very quickly, however, it is one of the best-controlled anaesthetic gases and is therefore very popular. Especially in obese patients Desfluran is absolutely indicated. Only strong concentration changes can lead to an increase in blood pressure and heart rate.

What role does gas anesthesia play today?

Gas narcosis is still one of the most important and frequently used forms of narcosis. Gas anaesthesia is the preferred method, especially for long operations. A big advantage of gas anaesthesia is the good controllability and monitoring possibility of the anaesthesia.During each gas anaesthesia, the exact supply (inspiratory gas concentration) and export (expiratory gas concentration) is measured.

This provides information about the concentration at the site of action, i.e. the central nervous system, and thus leads to a safe sleep without waking phases. The positive effect on the bronchial tubes also makes gas anaesthesia a popular anaesthetic procedure, especially for asthmatics. Only in patients who are prone to severe post-operative nausea, at risk of developing malignant hypertension, or have elevated intracranial pressure, a total intravenous form of anaesthesia (TIVA) is preferred to gas anaesthesia.

Laughing gas is an anaesthetic gas which used to be very common in anaesthesia and was very popular because of its both hypnotic and analgesic (pain-relieving) effects. However, nitrous oxide is not sufficient to maintain an anaesthesia and must always be combined with another anaesthetic gas. Due to its analgesic effect, anaesthesia with laughing gas requires only a small amount of additional painkillers.

As nitrous oxide has the property to diffuse into all air-filled rooms, it is contraindicated in many procedures, for example in the intestine. Furthermore, studies have shown that patients are more prone to severe post-operative nausea and vomiting after anaesthesia with nitrous oxide. A serious complication can occur at the end of an anaesthetic with laughing gas.

Since the nitrous oxide is released very quickly, ventilation with pure oxygen may be necessary, which is toxic for the lungs and causes severe damage. Due to the many side effects and newer, more controllable gas narcotics, nitrous oxide no longer plays a role in clinical routine. Xenon is a noble gas, which can also be used very well for anaesthesia. Similar to laughing gas, it has not only a hypnotic but also an analgesic effect. However, the side effects of xenon in clinical application have not yet been sufficiently clarified, which is why it has not yet been established in clinical routine and is still being researched in animal experiments.