Nitrous oxide, nausea, and vomiting after outpatient gynecologic surgery

The aim of this study was to establish whether nitrous oxide has a clinically important effect on postoperative vomiting in children after myringotomy. We studied 320 healthy children of ages 0. Vomiting after general anaesthesia in children is common and may result in considerable postoperative morbidity.This vomiting is of multifactorial aetiology of which nitrons oxide is a possible contributing factor. Nitrous oxide may induce vomiting by causing bowel distension, decreasing gastric motility, increasing middle ear pressure or interacting with endogenous opioid receptors. ~-3Among adults undergoing minor gynaecological surgery, as little as a 10-14 min exposure to N202 has been associated with increased vomiting. 3 Overall, the resuits of adult investigations have been controversial. Both an emetic 2-5 and lack of effect 6-9 have been reported. There have been two paedia~c studies. Pandit et al. failed to demonstrate a difference in vomiting after tonsiUectomy (62% vs 76%). 6 In another study of 104 children, nitrous oxide increased vomiting after myringotomy from 4% to CAN J ANAESTH 1995 / 42:4 / pp 274-6

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“…Similar to Felts et al 2 we were unable to demonstrate that duration of anaesthesia had an effect on post-anaesthesia emesis.…”

Section: Discussionsupporting

confidence: 47%

Nitrous oxide does not increase vomiting in children after myringotomy

et al. 1995

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“…While inhalation anesthetics can cause PONV in the early 0-to 2-hour postoperative period, there appears to be no difference in the incidence of PONV risk between desflurane and sevoflurane or between these agents and isoflurane [27,28]. Nitrous oxide (N 2 O) has been shown to increase PONV risk by direct stimulation of the vomiting center and sympathetic nervous system [29][30][31][32]. Peripheral N 2 O stimulation occurs by the distention of air containing spaces of the middle ear, GI tract and gallbladder [33].…”

Section: Anesthesia-related Risk Factorsmentioning

confidence: 98%

Prevention and Treatment of Postoperative Nausea and Vomiting

Kovac¹

2003

Antiemetic Therapy

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“…The time to loss of consciousness, and desflurane concentration at that time, were greater in the presence of nitrous oxide, despite the higher total MAC fraction administered in that group. Similarly, the incidences of nausea and vomiting, and the requirement for anti-emetics, were higher in group 3 (despite the previously reported emetic effect of nitrous oxide [7], and the fact that this was the only group in which the administration of nitrous oxide was avoided); only the differences in antiemetic dosage reached statistical significance. The possible anti-emetic effect of propofol(81 was not apparent, although the numbers in each group are small, and the possibility of a Type I1 error must be considered.…”

Section: Discussionmentioning

confidence: 60%

A comparison between propofol and desflurane anaesthesia for minor gynaecological laparoscopic surgery

Graham

Aitkenhead²

1993

Anaesthesia

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SummaryFfty-seven healthy female patients who underwent gynaecological laparoscopic surgery received either despurane or propofol for induction and maintenance of anaesthesia. Inhalational induction was generally well tolerated, and consciousness was lost in approximately 2 rnin (mean end-tidal concentrations ofdespurane were 8.3% with 60% nitrous oxide, and 7.1% with oxygen). Recovery of consciousness and orientation were more rapid in patients in whom anaesthesia was maintained with desjurane than with propofol, but there were no differences in psychomotor function test scores at 30 min. The data suggest that desjurane provides controllable anaesthesia and rapid recovery of consciousness after laparoscopic surgery.

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Nitrous oxide, nausea, and vomiting after outpatient gynecologic surgery

Cited by 78 publications

References 6 publications

Nitrous oxide does not increase vomiting in children after myringotomy

Nitrous oxide does not increase vomiting in children after myringotomy

Prevention and Treatment of Postoperative Nausea and Vomiting

A comparison between propofol and desflurane anaesthesia for minor gynaecological laparoscopic surgery

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