Nitrous oxide (N2O) reduces postoperative opioid-induced hyperalgesia after remifentanil–propofol anaesthesia in humans

Echevarría, Ghislaine C.; Elgueta, Francisca; Fierro, Camila; Bugedo, Diego A.; Faba, Gabriel; Iñiguez-Cuadra, Rodrigo; Muñoz, Hernán R.; Cortínez, Luis Ignacio

doi:10.1093/bja/aer323

Cited by 80 publications

(56 citation statements)

References 33 publications

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“…48 Nevertheless, there is a lack of clinical trials evaluating the role of N 2 O to reduce PPSP. One retrospective analysis of data from a study designed for other purposes suggested a likely preventive effect of N 2 O to decrease PPSP.…”

Section: Ketaminementioning

confidence: 99%

See 1 more Smart Citation

Potential strategies for preventing chronic postoperative pain: a practical approach: Continuing Professional Development

Richebé

Julien

Brulotte

2015

Can J Anesth/J Can Anesth

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Section: Ketaminementioning

confidence: 99%

“…48 Néanmoins, il n'y a pas d'étude clinique qui a évalué le rôle du N 2 O dans la réduction des DCPC. Seule une analyse rétrospective de données émanant d'une étude conçue à d'autres fins a suggéré un effet préventif probable de l'administration de N 2 O peropératoire sur les DCPC.…”

Section: Kétamineunclassified

Potential strategies for preventing chronic postoperative pain: a practical approach: Continuing Professional Development

Richebé

Julien

Brulotte

2015

Can J Anesth/J Can Anesth

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“…In another rat study, the NMDA receptor antagonist activity shown by N 2 O was seen to prevent hyperalgesia induced by opioids [8]. Therefore in a clinical study by Echeverria et al, they were shown that intraoperative 70% N 2 O administration significantly reduced postoperative opioid induced hyperalgesia in patients after septorhinoplasty operation [15]. A subgroup follow-up analysis of Enigma trial showed that intraoperative nitrous oxide administration was associated with a reduced risk of chronic postsurgical pain [16].…”

Section: Discussionmentioning

confidence: 97%

The Effects Of Nitrous Oxide On Postoperative Pain, Nausea Vomiting and Intraoperative Haemodynamics in Robotic Gynecologic Surgery

Yanli¹

2017

SDRP-JAS

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BACKGROUND n recent years there has been an increase in gynaecological operations performed with robotic surgery. In these procedures, nitrous oxide(N 2 O) or air are used together with inhalation anaesthestics. In this study we aimed to compare the effects of O 2 /N 2 O or O 2 /Air on postoperative pain, nausea vomiting (PONV) and intraoperative thermodynamics in robotic surgery. METHODSAged 28-71 years, classified ASA I-II, 58 patients were separated into 2 groups. Following induction, anaesthesia was maintained O 2 /Air (Group A) or O 2 /N 2 O (Group N) with sevoflurane. Heart rate (HR), mean arterial pressure (MAP), Central Venous Pressure (CVP), end tidal carbon dioxide (ETCO 2 ), peripheral oxygen saturation (SpO 2 ), Aldrete recovery score (ARS), postoperative nausea and vomiting (PONV) and visual analog scale (VAS) were recorded during the operation and postoperative period. RESULTSThe VAS values were higher in Group N at 5th min and higher in Group A at 150th min (p<0.05). In the intragroup analysis, VAS values were significantly lower at 120th, 150th, 180th min compared with 5th, 15th, 30th and 60th min in Group N (p<0.05). In Group A, the values at 15th, 30th min was significantly higher than 60th, 120th and 180th min (p<0.05). Intraoperative haemodynamic parameters (HR, MAP, CVP) were similar in two groups (p>0.05). Intragroup analysis of PONV values were significantly lower at 150th and 180th min compared with both 5th and 30th min in Group N and significantly higher at 5th min compared with 180th min in GroupA(p<0.05). CONCLUSIONWith regard to acute postoperative analgesia we could not find any significant difference between N 2 O and air. Further clinical studies are required to investigate this subject in respect of differences (at 5th min and at 150th min) in the VAS scores.

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“…Several studies have shown some usefulness on the prevention of a potential hyperalgesia related to perfusion of some opioids [2], and the decreased occurrence of postoperative chronic pain [23]. Moreover, the use of N 2 O has been established has a good practice [24], namely for promoting faster recoveries in the ambulatory surgery scenario [24].…”

Section: Nitrous Oxidementioning

confidence: 99%

“…This idea is growing in several areas, namely about the indication and safety to anesthetize pediatric patients [1], the use of intravenous infusions of opioids that might be related to the development of hyperalgesia [2], the advantages and drawbacks of the amount of oxygen to use [3] or even the current indication for the use of nitrous oxide [4].…”

Section: Introductionmentioning

confidence: 99%

O2 and N2O: Between the Rock and the Hard Place

Machado¹

2016

J Anesth Clin Res

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The use of oxygen and nitrous oxide is part of anesthetic practice since ever. These gases follow anesthetic practice in almost all types of clinical settings, procedures and patients. Their indications and limitations of use are well known.In recent years a great debate either in literature or in scientific meetings has been addressed, concerning the potential poor outcomes related to the use of certain amounts of oxygen and the use of nitrous oxide.The objective of this review is to gather information related to these two topics, based on the recent most relevant publications (2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016).Results show that both drugs have its advantages and drawbacks, and it is the clinical objective, the procedure, and the type of patient that will contribute the most for the anesthesiologist final decision.As a conclusion it was found that, 1) oxygen is a lifesaving drug on one side, but its use should be judicious since its high inspired fraction may have direct implications on that lung wellbeing, and 2) nitrous oxide has its known contraindications that should be taken into consideration and preclude its use when not clinically appropriate, however no evidence exists that indicates a formal discontinuation of its use, and in certain clinical scenarios it can be of relevant utility.

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Nitrous oxide (N2O) reduces postoperative opioid-induced hyperalgesia after remifentanil–propofol anaesthesia in humans

Abstract: Intraoperative 70% N(2)O administration significantly reduced postoperative OIH in patients receiving propofol-remifentanil anaesthesia.

Cited by 80 publications

References 33 publications

Potential strategies for preventing chronic postoperative pain: a practical approach: Continuing Professional Development

Potential strategies for preventing chronic postoperative pain: a practical approach: Continuing Professional Development

The Effects Of Nitrous Oxide On Postoperative Pain, Nausea Vomiting and Intraoperative Haemodynamics in Robotic Gynecologic Surgery

O2 and N2O: Between the Rock and the Hard Place

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