Nitrous oxide-based techniques versus nitrous oxide-free techniques for general anaesthesia

Jia, Wen; Zhang, Peng; Yang, Kehu; Tian, Jin Hui; Ma, Bin; Liu, Ya Li; Jia, Run H; Xiao, Luo; Kuriyama, Akira

doi:10.1002/14651858.cd008984.pub2

Cited by 25 publications

(17 citation statements)

References 99 publications

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“…It is known to increase the incidence of PONV via several different mechanisms, including stimulation of the central nervous system through catecholamine release, [ 26 ] induction of changes in middle ear pressure which subsequently influence the vestibular system, [ 27 ] and by an increase in abdominal bowel distension. [ 28 ] The association of N 2 O with severe PONV is especially strong in patients of Asian ethnicity. [ 16 ]…”

Section: Discussionmentioning

confidence: 99%

Effects of remifentanil versus nitrous oxide on postoperative nausea, vomiting, and pain in patients receiving thyroidectomy

Kim

Yi²,

Kang³

et al. 2016

Medicine

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Remifentanil and nitrous oxide (N2O) are 2 commonly used anesthetic agents. Both these agents are known risk factors for postoperative nausea and vomiting (PONV). However, remifentanil and N2O have not been directly compared in a published study. Remifentanil can induce acute tolerance or hyperalgesia, thus affecting postoperative pain. The objective of this retrospective study is to compare the effects of remifentanil and N2O on PONV and pain in patients receiving intravenous patient-controlled analgesia (IV-PCA) after thyroidectomy.We analyzed the electronic medical records of 992 patients receiving fentanyl-based IV-PCA after thyroidectomy at Chung-Ang University Hospital from January 1, 2010 to April 30, 2016. We categorized the patients according to anesthetic agents used: group N2O (n = 745) and group remifentanil (n = 247). The propensity score matching method was used to match patients in the 2 groups based on their covariates. Finally, 128 matched subjects were selected from each group.There were no differences between groups for all covariates after propensity score matching. The numeric rating scale for nausea (0.55 ± 0.88 vs 0.27 ± 0.76, P = 0.01) was higher and complete response (88 [68.8%] vs 106 [82.8%], P = 0.001) was lower in group N2O compared with group remifentanil on postoperative day 0. However, the visual analog scale score for pain (3.47 ± 2.02 vs 3.97 ± 1.48, P = 0.025) was higher in group remifentanil than group N2O on postoperative day 0.In patients receiving IV-PCA after thyroidectomy, postoperative nausea was lower but postoperative pain was higher in group remifentanil.

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Section: Discussionmentioning

confidence: 99%

Effects of remifentanil versus nitrous oxide on postoperative nausea, vomiting, and pain in patients receiving thyroidectomy

Kim

Yi²,

Kang³

et al. 2016

Medicine

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“…Moreover, while nitrous oxide does not alter bronchial diameter, it may cause pulmonary atelectasis associated with its uptake. 42 Accordingly, we wanted to exclude another variable on pulmonary aeration making evaluation of xenon-induced effects more difficult.…”

Section: Limitationsmentioning

confidence: 99%

Influence of xenon on pulmonary mechanics and lung aeration in patients with healthy lungs

Schaefer

Treschan

Gauch

et al. 2018

British Journal of Anaesthesia

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“…Nitrous oxide that is a relatively weak anaesthetic gas should need to be inhaled in high concentrations which restrict oxygen delivery (such as a common mixture is 30% oxygen with 70% nitrous oxide). 5 Many studies have shown that the nitrous oxide metabolic effects are linked to elevated plasma homocysteine levels and endothelial dysfunction perioperatively, 4 6 and nitrous oxide may possess potentially neuroprotective ability in animal models. 4 7 However, nitrous oxide also has neurotoxic and pro-neurotoxic action under other certain conditions, 8 9 10 11 so in this article, we will discuss the influence of nitrous oxide for stroke injury and the potential mechanisms on the basis of experimental and clinical studies to explore the feasibility of treatment.…”

Section: Introductionmentioning

confidence: 99%

The role of nitrous oxide in stroke

et al. 2017

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Stroke that is caused by poor blood flow into the brain results in cell death, including ischemia stroke due to lack of blood into brain tissue, and hemorrhage due to bleeding. Both of them will give rise to the dysfunction of brain. In general, the signs and symptoms of stroke are the inability of feeling or moving on one side of body, sometimes loss of vision to one side. Above symptoms will appear soon after the stroke has happened. If the symptoms and signs happen in 1 or 2 hours, we often call them as transient ischemic attack. Moreover, hemorrhagic stroke often leads to severe headache. It is known that neuronal death can happen after stroke, and it depends upon the activation of N-methyl-D-aspartate (NMDA) excitatory glutamate receptor which is the goal for a lot of neuroprotective agents. Nitrous oxide was discovered by Joseph Priestley in 1772, and then he and his friends, including the poet Coleridge and Robert Sauce, experimented with the gas. They found this gas could make patients loss the sense of pain and still maintain consciousness after inhalation. Shortly the gas was used as an anesthetic, especially in the field of dentists. Now, accroding to theme of Helene N. David and other scientists, both of nitrous oxide at 75 vol% and xenon at 50 vol% could reduce ischemic neuronal death in the cortex by 70% and decrease NMDA-induced Ca2+ influx by 30%. Therefore, more clinical and experimental studies are important to illuminate the mechanisms of how nitrous oxide protects brain tissue and to explore the best protocol of this gas in stroke treatment.

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Nitrous oxide-based techniques versus nitrous oxide-free techniques for general anaesthesia

Cited by 25 publications

References 99 publications

Effects of remifentanil versus nitrous oxide on postoperative nausea, vomiting, and pain in patients receiving thyroidectomy

Effects of remifentanil versus nitrous oxide on postoperative nausea, vomiting, and pain in patients receiving thyroidectomy

Influence of xenon on pulmonary mechanics and lung aeration in patients with healthy lungs

The role of nitrous oxide in stroke

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