A comparison of N2O/O2 versus Air/O2 gas mixtures in total intravenous anesthesia
during elective endovascular coil embolization
Background and Goal of Study: Since Guglielmi detachable coil embolization has been
introduced as a potential alternative treatment for intracranial aneurysms (IA), endovascular technology is one of well established methods for treating intracranial aneurysms. This procedure is usually performed under general anesthesia. Some authorities suggest that N2O is not suitable for this procedure because it increase the risk of air embolism.1 The aim of our study was to investigate whether the use of N2O can increase risk of air embolism during coil embolization for IA, compared with Air/O2 gas mixtures in total intravenous anesthesia.
Materials and Methods: With the approval of IRB, 95 patients for elective endovascular coil embolization were enrolled and randomly allocated into two group; N2O group (N2O/O2; 50:50, n=49) or AIR group remifentanil/propofol, n=46). MRI for diffusion-weighted imaging (DWI) was performed 24 hours after embolization and the number of lesions was evaluated by two study blinded radiologists. Additionally, Modified Rankin Scale (mRS)2 and complications were compared.
Results and discussion: There is no difference in demographics and anesthetic time between groups. The DWI analysis showes no difference in the number of embolic lesions between groups. The mRS scores after procedure are lower than those before procedure in both groups (p < 0.05), but have no difference between groups. The complications after treatment show no difference between groups.
Conclusion(s): Nitrous oxide/oxygen gas mixtures with intravenous anesthesia dose not
increase risk of air embolism during intracranial coil embolization

A comparison of N2O/O2 versus Air/O2 gas mixtures in total intravenous anesthesia during elective endovascular coil embolization