Omission of Nitrous Oxide during Anesthesia Reduces the Incidence of Postoperative Nausea and Vomiting

Divatia, Jigeeshu V.; Vaidya, JS; Badwe, Rajendra; Hawaldar, Rohini

doi:10.1097/00000542-199611000-00014

Cited by 180 publications

(64 citation statements)

References 58 publications

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“…In addition to studies showing that N 2 O increases postoperative nausea and vomiting [26][27][28], there are also studies showing that it has no effect [17,29,30].The effective prophylaxis and treatment would be diminish the risk of PONV [31]. Furthermore another meta-analysis show that the influence of N 2 O on PONV, with its relative risk approximately 1.4, is relatively low [32]. Also, Apfel et al [33], pointed out the main cause of early (0-2 h) PONV is the use of volatile anesthetics rather than N 2 O.…”

Section: Discussionmentioning

confidence: 99%

The Effects Of Nitrous Oxide On Postoperative Pain, Nausea Vomiting and Intraoperative Haemodynamics in Robotic Gynecologic Surgery

Yanli¹

2017

SDRP-JAS

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BACKGROUND n recent years there has been an increase in gynaecological operations performed with robotic surgery. In these procedures, nitrous oxide(N 2 O) or air are used together with inhalation anaesthestics. In this study we aimed to compare the effects of O 2 /N 2 O or O 2 /Air on postoperative pain, nausea vomiting (PONV) and intraoperative thermodynamics in robotic surgery. METHODSAged 28-71 years, classified ASA I-II, 58 patients were separated into 2 groups. Following induction, anaesthesia was maintained O 2 /Air (Group A) or O 2 /N 2 O (Group N) with sevoflurane. Heart rate (HR), mean arterial pressure (MAP), Central Venous Pressure (CVP), end tidal carbon dioxide (ETCO 2 ), peripheral oxygen saturation (SpO 2 ), Aldrete recovery score (ARS), postoperative nausea and vomiting (PONV) and visual analog scale (VAS) were recorded during the operation and postoperative period. RESULTSThe VAS values were higher in Group N at 5th min and higher in Group A at 150th min (p<0.05). In the intragroup analysis, VAS values were significantly lower at 120th, 150th, 180th min compared with 5th, 15th, 30th and 60th min in Group N (p<0.05). In Group A, the values at 15th, 30th min was significantly higher than 60th, 120th and 180th min (p<0.05). Intraoperative haemodynamic parameters (HR, MAP, CVP) were similar in two groups (p>0.05). Intragroup analysis of PONV values were significantly lower at 150th and 180th min compared with both 5th and 30th min in Group N and significantly higher at 5th min compared with 180th min in GroupA(p<0.05). CONCLUSIONWith regard to acute postoperative analgesia we could not find any significant difference between N 2 O and air. Further clinical studies are required to investigate this subject in respect of differences (at 5th min and at 150th min) in the VAS scores.

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Section: Discussionmentioning

confidence: 99%

The Effects Of Nitrous Oxide On Postoperative Pain, Nausea Vomiting and Intraoperative Haemodynamics in Robotic Gynecologic Surgery

Yanli¹

2017

SDRP-JAS

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“…Although there was no signifi cant difference between the groups with and without N 2 O in the prevalence of nausea and vomiting at the postoperative 0-2 hours, there was a signifi cant difference in the nausea at the postoperative 2-24 hours and the frequency of antiemetic use (20,(23)(24)(25)(26). The mechanism of nausea and vomiting due to N 2 O establishes via intraabdominal distension, besides via stimulation of CTZ or nausea center in medullae (3). Despite the fact that the mean IAP was 7.6 cm-H 2 O in the group in which N 2 O had been administered, and 5.36 cmH 2 O in the group in which N 2 O had not been administered in our study, the incidence of nausea and vomiting was found to be 5 % in both groups.…”

Section: Tab 3 the Mean Arterial Pressure Values Of The Groups (Meamentioning

confidence: 93%

“…Although the rate of moderate-severe intestinal distention was 23 % in the fi rst and 9 % in the second group, the incidence of postoperative nausea and vomiting was similar (20). Although there was no signifi cant difference between the groups with and without N 2 O in the prevalence of nausea and vomiting at the postoperative 0-2 hours, there was a signifi cant difference in the nausea at the postoperative 2-24 hours and the frequency of antiemetic use (20,(23)(24)(25)(26). The mechanism of nausea and vomiting due to N 2 O establishes via intraabdominal distension, besides via stimulation of CTZ or nausea center in medullae (3).…”

Section: Tab 3 the Mean Arterial Pressure Values Of The Groups (Meamentioning

confidence: 96%

“…In another study, in patients receiving PONV prophylaxis, the prevalence of PONV was decreased at a rate of 12 % in the group which received nitrogen instead of N 2 O (7). N 2 O causes an increase in the prevalence of postoperative vomiting when used with potent inhalation agents, especially in women undergoing laparoscopic interventions (22)(23)(24). It has been reported that N 2 O causes a dose-dependent increase in the incidence of PONV after gynecological laparoscopic surgery.…”

Section: Tab 3 the Mean Arterial Pressure Values Of The Groups (Meamentioning

confidence: 99%

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Effect of N2O on nausea and vomiting via intraabdominal pressure

Yüce¹,

Göktaş²,

Katı³

et al. 2012

BLL

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Background and objective:In this study we aimed to investigate whether there is an effect of N 2 O on postoperative nausea and vomiting (PONV) via intraabdominal pressure (IAP). Methods: A total of 40 patients with risk class ASA I-II and age ranging between 20 and 50 years were enrolled in the study. The patients were monitored for electrocardiography (ECG), peripheral oxygen saturation (SpO 2 ), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP), end-tidal carbon dioxide (ETCO 2 ) and body temperature. IAP was measured by a central venous pressure manometer placed in the urine catheter. Heart rate (HR), SpO 2 , SBP, DBP, MBP, ETCO 2 , body temperature and IAP were measured before the induction of anesthesia and every 10 minutes throughout the operation. Nausea and vomiting were questioned at the fi rst and second postoperative hours. The patients were randomly grouped into two groups. Induction in both groups was provided using 2 mg/kg propofol, 2 μg/kg fentanyl and 0.1 mg/kg vecuronium, and endotracheal intubation was performed. The maintenance of anesthesia was provided by 40 % O 2 + 60 % N 2 O, 1-2 % sevofl urane and 50 μg fentanyl + 2 mg vecuronium every 45 minutes in the fi rst group. In the second group, 60 % dry air was used instead of 60 % N 2 O. Results: There was no signifi cant difference in terms of HR, SpO 2 , SBP, MBP, ETCO 2 , body temperature, nausea-vomiting and IAP. Conclusions: In conclusion, we think that N 2 O usage during the general anesthesia in patients without intraabdominal problems may increase IAP level for some degree whereas it does not increase PONV. In addition, N 2 O usage does not change ETCO 2 values (Tab. 3, Fig. 3, Ref. 32). Full Text in PDF www.elis.sk.

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“…Omission of N 2 O significantly reduced PONV in several meta-analyses, [10][11][12][13] but the risk of intraoperative awareness was also increased. 12 In most meta-analyses, propofol was associated with a lower frequency of PONV when used for total iv anesthesia in the absence of N 2 O.…”

Section: Résultats : Aucune Différence Intergroupe N'a éTé Enregistrémentioning

confidence: 95%

Induction with sevoflurane-remifentanil is comparable to propofol-fentanyl-rocuronium in PONV after laparoscopic surgery

Yang

Choi

McChesney

et al. 2004

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : To compare sevoflurane-remifentanil induction and propofol-fentanyl-rocuronium induction with regards to the frequency of moderate to severe postoperative nausea and vomiting (PONV) in the first 24 hr after laparoscopic day surgery.M Me et th ho od ds s: : After informed consent, 156 ASA physical status class I to III patients undergoing laparoscopic cholecystectomy or tubal ligation were randomized to either induction with sevoflurane 8%, N 2 O 67% and iv remifentanil 1 to 1.5 µg·kg -1 or induction with iv fentanyl 2 to 3 µg·kg -1 , propofol 2 mg·kg -1 , and rocuronium 0.3 to 0.5 mg·kg -1 . All patients received iv ketorolac 0.5 mg·kg -1 at induction and sevoflurane-N 2 O maintenance anesthesia with rocuronium as needed. PONV was treated with iv ondansetron, droperidol, or dimenhydrinate; postoperative pain was treated with opioid analgesics. Patients were followed for 24 hr with regards to PONV and pain. Intubating conditions, induction and emergence times, time to achieve fast-track discharge criteria, and drug costs were measured. R Re es su ul lt ts s: : No differences were seen between the two groups in their frequencies of 24-hr moderate to severe PONV and postoperative pain, or in their intubating conditions, induction and emergence times, and time to achieve fast-track discharge criteria. Patients undergoing sevoflurane-remifentanil induction received more morphine (11 mg vs 8 mg; P < 0.001) in the postanesthetic care unit. Sevoflurane-remifentanil induction resulted in similar anesthetic and total drug costs for both procedures.C Co on nc cl lu us si io on n: : We did not demonstrate any difference in PONV, pain, or anesthetic/recovery times or costs between the sevoflurane and propofol groups. Sevoflurane-remifentanil induction is a feasible technique for anesthetic induction. Objectif : Comparer l'induction avec sévoflurane-rémifentanil ou propofol-fentanyl-rocuronium quant à la fréquence de nausées et vomissements postopératoires (NVPO) de modérés à sévères pendant les 24 premières heures après une opération en chirurgie d'un jour sous laparoscopie. Méthode : Après avoir accordé leur consentement, 156 patients d'état

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Omission of Nitrous Oxide during Anesthesia Reduces the Incidence of Postoperative Nausea and Vomiting

Abstract: Omission of nitrous oxide reduced the odds of postoperative nausea and vomiting by 37%, a reduction in risk of 28%.

Cited by 180 publications

References 58 publications

The Effects Of Nitrous Oxide On Postoperative Pain, Nausea Vomiting and Intraoperative Haemodynamics in Robotic Gynecologic Surgery

The Effects Of Nitrous Oxide On Postoperative Pain, Nausea Vomiting and Intraoperative Haemodynamics in Robotic Gynecologic Surgery

Effect of N2O on nausea and vomiting via intraabdominal pressure

Induction with sevoflurane-remifentanil is comparable to propofol-fentanyl-rocuronium in PONV after laparoscopic surgery

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