The use of short-induction nitrous oxide and oxygen with Penthrane; a new concept in pediatric oral surgical anesthesia

Abstract

Abstract 1. 1. The inhalant drug, methoxyflurane, a fluorinated ether marketed as Penthrane, is the newest member of the halogen family of anesthetic agents. It is the first clinically useful, nonexplosive ether to be introduced. It is described physically as a clear liquid with a high boiling point, a low saturated vapor pressure, and a pleasant odor. In addition to its nonflammable properties, the drug is stable in the presence of air, alkali, light, and moisture, and it can be used safely in a closed-circuit system. 2. 2. We initiated the use of Penthrane early in 1963, subsequent to a number of previously published reports which evaluated clinical experience with this agent. Our own clinical experience has substantiated specific advantages which we consider to be of merit in the administration of pediatric analgesia and anesthesia for office oral surgical procedures. These advantages include (1) rapid induction; (2) early and profound relaxation of extremities; (3) ease of administration with reference to procedure and equipment; (4) the safety factor attendant to the administration of inhalants with low saturated vapor pressure wherein precipitous induction, initial overdose, and early saturation levels are difficult to produce; (5) apparent lack of associated hepatocellular toxicity, cardiovascular alterations, or measurable effect on the coagulation mechanism; (6) pharmacological compatibility with other drugs ordinarily employed during the conduct of anesthesia; (7) good early analgesia in the light planes, which then extends into emergence; and (8) rapid recovery. 3. 3. For purposes of general evaluation, therefore, we instituted an analysis of Penthrane and nitrous oxide-oxygen anesthetic in a randomly selected series of 301 pediatric oral surgical patients. In the series analysis, the median induction time was 3 minutes. The median total Penthrane time was also 3 minutes, and the median total anesthesia time was 5 minutes. The median recovery time was 3 minutes, and the median recovery-room time was 17 minutes. Vomiting incidence was 7.6 per cent. 4. 4. We have used Penthrane for more than 3,000 office procedures and have found that it has several favorable characteristics which make it applicable to outpatient anesthesia. We believe Penthrane to be a very effective and useful general anesthetic for use in the oral surgery office because of its inherent properties of rapid induction, safety , and rapid recovery .