Pasarón Raquel, Burnweit Cathy, Zerpa Jeannette, Malvezzi Leopoldo, Knight Colin, Shapiro Tina, Ramos-Irizarry Carmen, Velis Evelio
Department of Pediatric Surgery, Miami Children's Hospital, 3200 SW 60 Court, Suite 201, Miami, FL, 33155, USA,
Pediatr Surg Int. 2015 Feb;31(2):173-80. doi: 10.1007/s00383-014-3608-5. Epub 2014 Nov 11.
Nitrous oxide's safety and efficacy for minor procedures is an alternative to general anesthesia, complex sedation protocols, or local anesthetic alone.
A retrospective review of prospectively-collected data (2000-2012) identified 1,058 children who received single-agent nitrous oxide for minor surgery.
Children (n = 1,058, male 42 %, female 58 %) aged 1-23 years (mean = 9.8 + 5.1 years) were identified. Only nine children (0.9 %) fasted. ASA status was I-II in 1,053 (99.5 %) of patients; five (0.5 %) had an ASA III. There were no major complications (desaturation, emergency admission, apnea, airway obstruction, bradycardia) or aborted procedures. Minor complications occurred in 1.8 %; there was no association between these complications and ASA, fasting status or maximum nitrous oxide percentage administered (all p > 0.05). Post-operatively, 98 % of patients denied getting an injection. Eighty-two percent reported mild or no procedural pain.
This is the longest reported study using non-anesthesiologist-administered nitrous oxide as a single-agent for minor surgical procedures. The technique provides safe sedation and excellent amnesia, allowing pain and anxiety-reduced surgery with no fasting or postoperative monitoring.
一氧化二氮用于小型手术的安全性和有效性是全身麻醉、复杂镇静方案或单纯局部麻醉的替代方法。
对前瞻性收集的数据（2000 - 2012年）进行回顾性分析，确定了1058例接受单剂一氧化二氮进行小型手术的儿童。
确定了年龄在1 - 23岁（平均9.8±5.1岁）的儿童（n = 1058，男性42%，女性58%）。仅9名儿童（0.9%）禁食。1053例（99.5%）患者的ASA分级为I - II级；5例（0.5%）为ASA III级。无重大并发症（低氧血症、急诊入院、呼吸暂停、气道梗阻、心动过缓）或手术中止情况。轻微并发症发生率为1.8%；这些并发症与ASA分级、禁食状态或一氧化二氮最大使用百分比之间均无关联（所有p>0.05）。术后，98%的患者否认接受过注射。82%的患者报告手术疼痛轻微或无疼痛。
这是报道的使用非麻醉医生给予单剂一氧化二氮进行小型外科手术的最长研究。该技术提供安全的镇静和良好的遗忘效果，允许在无需禁食或术后监测的情况下进行减轻疼痛和焦虑的手术。
