Anaesthesia Department, Hospital Rúber, Madrid, Spain.
Anaesthesia. 2010 Apr;65(4):379-87. doi: 10.1111/j.1365-2044.2010.06249.x. Epub 2010 Feb 11.
Some, but not all studies have suggested intra-operative use of nitrous oxide is correlated with postoperative nausea and vomiting. We performed a meta-analysis of randomised controlled trials to compare the incidence of nausea and vomiting in adults following general anaesthesia with or without nitrous oxide. We retrieved 30 studies (incorporating 33 separate trials) that investigated a 'nitrous oxide group' (total 2297 patients) vs a 'no-nitrous oxide group' (2301 patients). Omitting nitrous oxide significantly reduced postoperative nausea and vomiting (pooled relative risk 0.80, 95% CI 0.71-0.90, p = 0.0003). However, the absolute incidence of nausea and vomiting was high in both the nitrous oxide and no-nitrous oxide groups (33% vs 27%, respectively). In subgroup analysis, the maximal risk reduction was obtained in female patients (pooled relative risk 0.76, 95% CI 0.60-0.96). When nitrous oxide was used in combination with propofol, the antiemetic effect of the latter appeared to compensate the emetogenic effect of nitrous oxide (pooled relative risk 0.94, 95% CI 0.77-1.15). We conclude that avoiding nitrous oxide does reduce the risk of postoperative nausea and vomiting, especially in women, but the overall impact is modest.
一些，但不是所有的研究表明，术中使用一氧化二氮与术后恶心和呕吐有关。我们对随机对照试验进行了荟萃分析，以比较全身麻醉中使用和不使用一氧化二氮的成年人术后恶心和呕吐的发生率。我们检索了 30 项研究（包含 33 项单独的试验），调查了“一氧化二氮组”（共 2297 例患者）与“无一氧化二氮组”（2301 例患者）。不使用一氧化二氮显著降低了术后恶心和呕吐的发生率（汇总相对风险 0.80，95%置信区间 0.71-0.90，p = 0.0003）。然而，一氧化二氮组和无一氧化二氮组的术后恶心和呕吐的绝对发生率都很高（分别为 33%和 27%）。亚组分析显示，女性患者的最大风险降低（汇总相对风险 0.76，95%置信区间 0.60-0.96）。当一氧化二氮与异丙酚联合使用时，后者的止吐作用似乎补偿了一氧化二氮的致吐作用（汇总相对风险 0.94，95%置信区间 0.77-1.15）。我们的结论是，避免使用一氧化二氮确实可以降低术后恶心和呕吐的风险，尤其是在女性中，但总体影响较小。
