Change in Cerebrospinal Fluid Pressure During Pneumoencephalography Under Nitrous Oxide Anesthesia

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Abstract
An increase in cerebrospinal fluid pressure occurs in dogs and humans anesthetized with nitrous oxide after air was injected into the cerebral ventricles. The mechanism for the increase in pressure is felt to be due to the difference in blood solubility between nitrous oxide and N. Nitrous oxide, being 30 times more soluble in blood than N, is carried to the air-containing ventricles in a greater quantity than the amount of N that can be carried away from the ventricles. The result is an increased number of molecules within the ventricles and an increase in intraventricular pressure. This pressure increase might prove fatal, especially in an individual whose cerebrospinal fluid pressure is already elevated. Either the avoidance of nitrous oxide anesthesia or the use of nitrous oxide as the contrast gas would eliminate the rise in pressure.