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

Abstract

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.