Jensen A G, Prevedoros H, Kullman E, Anderberg B, Lennmarken C
Department of Anaesthesiology, University Hospital, Linköping, Sweden.
Acta Anaesthesiol Scand. 1993 Oct;37(7):683-6. doi: 10.1111/j.1399-6576.1993.tb03789.x.
We have evaluated the effects of nitrous oxide on recovery following laparoscopic cholecystectomy in a prospective, randomised, double-blind study with 42 otherwise healthy patients. All patients received meperidine 1 mg/kg and atropine 6 micrograms/kg im for premedication, and anaesthesia was induced with fentanyl 2 micrograms/kg and thiopental 4-6 mg/kg. Succinylcholine was used for the intubation and muscle relaxation was achieved using vecuronium. Isoflurane with 70% nitrous oxide in oxygen and fentanyl was used for maintenance of anaesthesia in group I (n = 19), and isoflurane in air/oxygen and fentanyl in group II (n = 23). The postoperative ward staff and the surgeon evaluating the postoperative recovery were blinded to the anaesthetic technique. No differences were found in duration of operation and anaesthesia, need for postoperative analgesia or postoperative nausea treated medically. Recovery, judged by the Steward Coma Score, comprehension and collaboration, degree of sedation and orientation in time and space, was similar in the two groups. Postoperative hospital stay was 1 (1-4) day in the nitrous oxide group (median (10-90th percentiles) versus 2 (1-4) days in the air group. The time until patients were recovered, as judged by return to work and normal daily activities, was the same in the two groups: 8 (4-11) days in the nitrous oxide group and 8 (4-11) days in the air group. We conclude that nitrous oxide has no influence on recovery after laparoscopic cholecystectomy.
我们在一项针对42名健康患者的前瞻性、随机、双盲研究中，评估了一氧化二氮对腹腔镜胆囊切除术后恢复的影响。所有患者术前均接受1mg/kg哌替啶和6μg/kg阿托品肌肉注射进行预处理，麻醉诱导采用2μg/kg芬太尼和4 - 6mg/kg硫喷妥钠。琥珀酰胆碱用于插管，维库溴铵用于维持肌肉松弛。第一组（n = 19）使用异氟烷、70%一氧化二氮与氧气混合以及芬太尼维持麻醉，第二组（n = 23）使用异氟烷与空气/氧气混合以及芬太尼维持麻醉。术后病房工作人员和评估术后恢复情况的外科医生对麻醉技术均不知情。在手术时间、麻醉时间、术后镇痛需求或药物治疗的术后恶心方面未发现差异。根据管家昏迷评分、理解与合作能力、镇静程度以及时间和空间定向能力判断，两组的恢复情况相似。一氧化二氮组的术后住院时间为1（1 - 4）天（中位数（第10 - 90百分位数）），空气组为2（1 - 4）天。根据恢复工作和正常日常活动判断，两组患者恢复所需时间相同：一氧化二氮组为8（4 - 11）天，空气组为8（4 - 11）天。我们得出结论，一氧化二氮对腹腔镜胆囊切除术后的恢复没有影响。
