Nitrous oxide Epinephrine

Lampe GH, Donegan JH, Rupp SM, Wauk LZ, Whitendale P, Fouts KE, Rose BM, Litt LL, Rampil IJ, Wilson CB, et al. Nitrous oxide and epinephrine-induced arrhythmias. Anesth Analg 1990 71(6) 602-5. 

It is mostly used as an analgesic and anaesthetic agent to supplement the action of nitrous oxide. It should not be used with epinephrine. 

A 22-year-old woman in good health was anaesthetised for surgery with nitrous oxide/oxygen and isoflurane. Twenty minutes after induction she was given an injeetion of 0.2 units of vasopressin into the eervix. Within seeonds she developed severe hypotension and bradycardia, and over the next 30 minutes blood pressures as low as 70/35 mmHg and heart rates as low as 38 bpm were recorded. She was treated with atropine and adrenaline (epinephrine), and eventually made a full recovery. This patient was wearing a transdermal nicotine patch. ... 

Compound 347 (XXXVI) produced satisfactory anesthesia in dogs according to McDowell et al. but was not compatible with epinephrine and produced poor anaTgesia. Results obtained by Dobkin et al. when the drug was given with nitrous oxide-oxygen to 100 patients ndicated that it deserved further clinical evaluation. 

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