Orhan-Sungur Mukadder, Apfel Christian, Akça Ozan
Department of Anesthesiology and Perioperative Medicine and Outcomes Research Institute, University of Louisville, Louisville, Kentucky 40202, USA.
Curr Opin Anaesthesiol. 2005 Dec;18(6):620-4. doi: 10.1097/01.aco.0000188417.00011.78.
To evaluate evidence and present an objective view on the effect of nitrous oxide on bowel function.
We determined in a metaanalysis that the chance of having intraoperative bowel distension was increased about two fold in patients receiving nitrous oxide as the anaesthetic carrier gas compared with those receiving nitrogen or oxygen. In a separate logistic regression analysis, we found that the duration of nitrous oxide exposure was a key factor in explaining this difference, as well as the variability of previously published data. In contrast to bowel distension, surgical operating conditions were not hindered by the use of nitrous oxide; however, the number of patients analysed for operating conditions was much less than that for bowel distension data.
Nitrous oxide causes clinically and statistically recognizable bowel distension. This distension, however, does not always exacerbate the surgical conditions, nor does it appear to delay bowel movement or hospital discharge. Although no major problems were noted in bowel functions other than distension, we recommend avoiding nitrous oxide administration during prolonged bowel operations.
评估有关一氧化二氮对肠道功能影响的证据并给出客观观点。
我们通过一项荟萃分析确定，与接受氮气或氧气作为麻醉载气的患者相比，接受一氧化二氮作为麻醉载气的患者术中出现肠扩张的几率增加了约两倍。在另一项逻辑回归分析中，我们发现一氧化二氮暴露的持续时间是解释这种差异的关键因素，同时也是先前发表数据变异性的关键因素。与肠扩张相反，使用一氧化二氮并未妨碍手术操作条件；然而，用于分析手术操作条件的患者数量远少于用于肠扩张数据的患者数量。
一氧化二氮会导致临床上和统计学上可识别的肠扩张。然而，这种扩张并不总是会加剧手术条件，也似乎不会延迟排便或出院。尽管除了扩张之外，肠道功能未发现重大问题，但我们建议在长时间肠道手术期间避免使用一氧化二氮。
