Scheinin B, Lindgren L, Scheinin T M
Department of Anaesthesia, Surgical Hospital, Central University Hospital, Helsinki, Finland.
Br J Anaesth. 1990 Feb;64(2):154-8. doi: 10.1093/bja/64.2.154.
Forty patients scheduled for elective colonic surgery were allocated at random to receive either nitrous oxide or air during surgery. Preoperative management, surgery, parenteral therapy and postoperative analgesics were similar in both groups. Anaesthetic management included isoflurane, vecuronium by infusion and fentanyl 3 micrograms kg-1 h-1. The air group required a mean inspired isoflurane concentration of 0.8% (SD 0.3), whereas the nitrous oxide group required 0.4% (SD 0.2). No differences were found in duration of operation, blood loss, need for postoperative analgesia or postoperative nausea. Patients in the air group had less gas in the small bowel (P less than 0.005) and in the large bowel (P less than 0.001), and operating conditions were better than in the nitrous oxide group (P less than 0.01). After operation, the air group had significantly earlier bowel function than the nitrous oxide group, with earlier passing of flatus (3.4 (1.2) vs 4.7 (1.4) days) (P less than 0.05) and faeces (4.7 (1.5) vs 6.3 (2.2) days) (P less than 0.05) and required a shorter postoperative hospital stay (10.0 (1.3) vs 11.7 (2.5) days) (P less than 0.05).
40例计划接受择期结肠手术的患者被随机分配，在手术期间分别接受氧化亚氮或空气。两组患者的术前管理、手术、肠外治疗和术后镇痛措施相似。麻醉管理包括异氟烷、静脉输注维库溴铵和3微克/千克/小时的芬太尼。空气组吸入异氟烷的平均浓度为0.8%（标准差0.3），而氧化亚氮组为0.4%（标准差0.2）。在手术持续时间、失血量、术后镇痛需求或术后恶心方面未发现差异。空气组患者小肠（P<0.005）和大肠（P<0.001）内的气体较少，手术条件优于氧化亚氮组（P<0.01）。术后，空气组的肠功能恢复明显早于氧化亚氮组，排气时间更早（3.4（1.2）天对4.7（1.4）天）（P<0.05），排便时间更早（4.7（1.5）天对6.3（2.2）天）（P<0.05），术后住院时间更短（10.0（1.3）天对11.7（2.5）天）（P<0.05）。
