[Use of nitrous oxide in Uruguay]

BACKGROUND

Nitrous oxide (N2O) is a medicinal gas that has been used for anesthesia for over a century and a half. As evidence of the adverse effects of N2O have been contrasted with the good safety profiles of new anesthetic agents, use of the older gas has declined.

OBJECTIVE

To describe and analyze the use of N2O for anesthesia in the Eastern Republic of Uruguay. To describe the use of other drugs for general anesthesia.

METHODS

The study had 2 phases. In the first phase, information on the use of N2O and other drugs for general anesthesia was obtained from the medical records of a sample of patients who underwent surgery between November 2007 and November 2008 at nationally important hospitals. In the second phase 80 physician anesthesiologists were surveyed to obtain information on their reported use of N2O for general anesthesia. The respondents were found working during the first half of 2008.

RESULTS

A total of 104 patients' records were read and 80 anesthesiologists were surveyed. We found that 31 (29.8%) patients received N2O during anesthesia. The survey showed that 62 (77.5%) of the anesthesiologists had used N2O in the last 6 months. Nine (50%) of the anesthesiologists who had not used N2O said their reason was that it was unavailable. The other 9 referred either to the risk of postoperative nausea and/or vomiting (n = 6) or the fact of having better alternatives (n = 9).

CONCLUSION

This study shows that N2O is little used in current anesthesia practice. The tendency in Uruguay continues to be toward declining use.

Pilomatricoma: Sonographic features

Pilomatricomas (also known as calcifying epitheliomas of Malherbe) are benign subcutaneous tumors that arise from the cutaneous adnexa and usually affect young subjects. They typically present as solitary asymptomatic nodules located in most cases on the face or neck. On ultrasonography, pilomatricomas appear as hypoechoic lesions with inhomogeneous echo structures, well-defined margins, and posterior shadowing. Color Doppler generally reveals a single artery that penetrates the lesion and gives rise to multiple intralesional branches. Diagnosis is based on clinical and histological findings. The authors present a typical case of pilomatricoma diagnosed on the basis of clinical and sonographic findings that were subsequently confirmed by histology.