Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
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Akca, O; Lenhardt, R; Fleischmann, E; Treschan, T; Greif, R; Fleischhackl, R; Kimberger, O; Kurz, A; Sessler, DI.
Nitrous oxide increases the incidence of bowel distension in patients undergoing elective colon resection.
Acta Anaesthesiol Scand. 2004; 48(7):894-8
Doi: 10.1111/j.0001-5172.2004.00427.x
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- Co-Autor*innen der Med Uni Graz
- Kurz Andrea
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- Abstract:
- BACKGROUND: Nitrous oxide rapidly inflates gas-filled spaces such as the intestines; but whether the resulting bowel distension is clinically important remains unclear. We therefore tested the hypothesis that nitrous oxide produces clinically important bowel distension. METHODS: Patients scheduled for colon resection were anesthetized with isoflurane and 35% oxygen and randomly assigned to 65% nitrous oxide (n = 175) or 65% nitrogen in air (n = 169). At the end of surgery, blinded surgeons rated the degree of bowel distension as none, mild, moderate, or severe. Patients reported pain, and nausea and vomiting (PONV) 2 h after surgery. Data are reported as means (SD). P < 0.05 was statistically significant. RESULTS: Morphometric and demographic data were similar in the groups. The duration of surgery was 3.0 (1.2) h in the nitrous oxide group and 3.4 (1.5) h in the air group (P = 0.017). Postoperative self-reported pain scores (visual analog scale, 0-100 mm) were greater in the nitrous oxide group (43 [30] mm) than in the air group (35 [31] mm, P = 0.018). Although the incidence of PONV was similar in the groups, VAS scores for nausea were significantly greater in the nitrous oxide group (P = 0.040). Moderate-to-severe bowel distension was observed in 23% of nitrous oxide patients, but in only 9% of patients in the air group (P < 0.001). The number-needed-to-harm for moderate or severe bowel distension from nitrous oxide was thus seven. CONCLUSIONS: Our results suggest that avoiding nitrous oxide administration during prolonged bowel operations will minimize bowel distension and possibly reduce postoperative pain related to it.
- Find related publications in this database (using NLM MeSH Indexing)
- Adolescent - administration & dosage
- Adult - administration & dosage
- Aged - administration & dosage
- Aged, 80 and over - administration & dosage
- Colon - surgery
- Female - administration & dosage
- Humans - administration & dosage
- Incidence - administration & dosage
- Intestinal Diseases - chemically induced, epidemiology
- Male - administration & dosage
- Middle Aged - administration & dosage
- Nitrous Oxide - adverse effects
- Postoperative Nausea and Vomiting - epidemiology
- Pressure - administration & dosage
- Find related publications in this database (Keywords)
- anesthesia
- bowel distension
- nitrous oxide
- surgery