Yuce H H, Goktas U, Kati I, Cegin M B, Soyoral L
Department of Anesthesiology, Yuzuncu Yil University, Van, Turkey.
Bratisl Lek Listy. 2012;113(8):490-4. doi: 10.4149/bll_2012_108.
In this study we aimed to investigate whether there is an effect of N2O on postoperative nausea and vomiting (PONV) via intraabdominal pressure (IAP).
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 (SpO2), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP), end-tidal carbon dioxide (ETCO2) and body temperature. IAP was measured by a central venous pressure manometer placed in the urine catheter. Heart rate (HR), SpO2, SBP, DBP, MBP, ETCO2, 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 first 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 % O2 + 60 % N2O, 1-2 % sevoflurane and 50 µg fentanyl + 2 mg vecuronium every 45 minutes in the first group. In the second group, 60 % dry air was used instead of 60 % N2O.
There was no significant difference in terms of HR, SpO2, SBP, MBP, ETCO2, body temperature, nausea-vomiting and IAP.
In conclusion, we think that N2O 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, N2O usage does not change ETCO2 values (Tab. 3, Fig. 3, Ref. 32).
在本研究中,我们旨在调查氧化亚氮(N2O)是否通过腹腔内压力(IAP)对术后恶心呕吐(PONV)产生影响。
本研究共纳入40例美国麻醉医师协会(ASA)分级为I-II级、年龄在20至50岁之间的患者。对患者进行心电图(ECG)、外周血氧饱和度(SpO2)、收缩压(SBP)、舒张压(DBP)、平均血压(MBP)、呼气末二氧化碳(ETCO2)和体温监测。通过置于尿管中的中心静脉压测压计测量IAP。在麻醉诱导前及整个手术过程中每10分钟测量心率(HR)、SpO2、SBP、DBP、MBP、ETCO2、体温和IAP。在术后第1小时和第2小时询问患者恶心呕吐情况。将患者随机分为两组。两组均使用2mg/kg丙泊酚、2μg/kg芬太尼和0.1mg/kg维库溴铵进行诱导,并进行气管插管。第一组每45分钟使用40%氧气 + 60% N2O、1-2%七氟醚和50μg芬太尼 + 2mg维库溴铵维持麻醉。第二组使用60%干燥空气代替60% N2O。
在HR、SpO2、SBP、MBP、ETCO2、体温、恶心呕吐和IAP方面无显著差异。
总之,我们认为在无腹腔问题的患者全身麻醉期间使用N2O可能会在一定程度上提高IAP水平,但不会增加PONV。此外,使用N2O不会改变ETCO2值(表3,图3,参考文献32)。