The anesthetizing properties of xenon for the first time were described more than 50 flyings ago. It is the inert gas which is possessing a distribution coefficient "blood-gas" smaller, than at nitrous oxide, but having at the same time much higher anesthetizing activity. These properties provide fast induction in anesthesia and also a fast exit from it. In addition, xenon has own analgetic activity which does not depend on adrenergic and opioid systems. In comparison with other inert gases which have the anesthetizing activity, xenon too the only gas which is anesthetic in normobarichesky conditions.
Xenon is a normal component of atmospheric air and contains in it in concentration of 0.086 ppm. Originally xenon did not find broad application in world anesthesiology owing to the high cost as it cannot be made in the industrial way. However, development of technology of fractional distillation of xenon from the liquefied air, use of systems of recirculation, use by the low-line principle, revived interest in its clinical use. There is an opinion that if the problem of high cost of production of xenon is overcome, it has every chance of becoming ideal inhalation anesthetic.
Xenon is characterized by the minimum influence on system and pulmonary geodynamics that allows to apply it at the patients compromised in this regard. Functions of heart at its use practically do not change, contractility of a myocardium does not decrease. There are data on cardiotyre-tread and neurotyre-tread effects of xenon. At patients with serious cardial pathology xenon practically does not change parameters of a system hemodynamics.
Effects of xenon in relation to the system of breath consist in increase in pulmonary resistance and work of breath. Thus, it should be used carefully at persons with chronic pulmonary diseases, at patients with obesity and premature children.
Xenon is not exposed to metabolism in a liver and kidneys, has no teratogenic effect and does not cause a malignant hyperthermia. Positive ecological impact of xenon is that it does not destroy an ozone layer of a stratosphere and does not promote thereby progressing of greenhouse effect on the planet.
The mentioned own analgetic activity of xenon allows to reduce use of opiates at operations with its use (to 80% of fentanyl, according to some information). This circumstance serves as one more reason of much faster recovery of patients after xenon anesthesia, in comparison with other inhalation anesthetics. No advantages of total intravenous anesthesia in comparison with inhalation xenon were also shown.
Practically xenon is used in the form of xenon-oxygen mix. The IAC of xenon makes 71% that is much higher than that at nitrous oxide and allows to achieve deep anesthesia without risk of a hypoxia. The special narcotic devices counted on use of this anesthetic are used. Use of a gas analyzer in a contour is obligatory. In the beginning the careful denitrogenization and a preoksigenation as xenon has property to promote accumulation of nitrogen in a contour is carried out. One more problem consists in a saturation technique xenon at the initial stage of anesthesia as use in this case of the standard equipment of a high stream can be irrational because of the high cost of xenon. The most economic technology of use of xenon is anesthesia on the closed contour. In this case, consumption of xenon falls exponential with saturation of body tissues in the closed reverse rebreathing system, and, therefore, the gas consumption is considerably reduced.
Exit xenon comes from anesthesia very quickly thanks to its pharmacokinetic properties. Stop xenon supply, pass to breath 100% with oxygen. The ability of xenon to cause a diffusive hypoxia due to filling of alveoluses, is comparable to that at nitrous oxide therefore compulsory ventilation by oxygen upon completion of anesthesia always has to be carried out. There is a fast awakening of the patient, practically without any residual phenomena.
The xenon anesthesia received special popularity in out-patient stomatology where the combination of rather deep anesthesia to a fast exit from it is required. Xenon in stomatology is quite often combined with various techniques of a local anesthesia which is carried out after anesthesia approach. It allows to avoid use of opiates and to provide qualitative intra-and a postoperative analgesia.