Chloroethane: Difference between revisions

'''Chloroethane''' (also known as '''ethyl chloride''', or '''spray poppers,''' and under various trade names such as ''Maximum Impact®'' and ''Black Max®'') is a volatile organic solvent which produces rapid-onset intoxication when its vapors are inhaled. It is toxic and lethal in high concentrations. Recreational use is extremely dangerous due to the essentially unmitigable risk of sudden death.

Chloroethane was previously used as an inhalational anesthetic to produce general anesthesia. However, its flammability, toxicity, and pharmacokinetics have led to it being replaced by more modern agents such as sevoflurane. It is still sometimes used as a local anesthetic due to the chilling effect produced by topical evaporation.

Chloroethane is thought to produce intoxication primarily through GABA receptor agonism, similar to other volatile anesthetics.

The difference in dose of chloroethane between the desired recreational effects and cardiac arrest is very small (<10% difference in the concentration of gas). Because chloroethane boils into a gas at room temperature, it is possible to produce extremely high concentrations of gas (>50%) if it is inhaled from a confined space such as a rag. Furthermore, it is practically impossible to accurately monitor and control the concentration of chloroethane being inhaled. '''<u>These characteristics mean that cardiac arrest can rapidly occur without warning during any use.</u>'''

One major risk of chloroethane is the involuntary activation of airway reflexes, including [[laryngospasm]] (closure of the vocal cords), or [[bronchospasm]] (closure of the lower airways), resulting in partial or complete blockage of airflow to and from the lungs. Normally, these reflexes are protective and are triggered to prevent liquids or solids from entering the lungs. However, when unconsciousness is caused by an anesthetic agent, these reflexes can activate inappropriately even when no triggering stimulation was present, and may not relax once activated.

If laryngospasm occurs, it can sometimes be treated with [[Larson's maneuver]] (using fingers to apply firm inward pressure to the soft tissue directly underneath the ear lobe on both sides of the head). If a bag-valve-mask is present, positive pressure with a high inspiratory pressure may also resolve the episode. However, '''<u>some cases of laryngospasm will not resolve until death occurs</u>''' and can only be managed by trained experts with access to specialized medications and equipment.