The influence of nitrous oxide on propofol dosage and recovery after total intravenous anaesthesia for day‐case surgery

Abstract

SummaryWe studied the influence of

Nitrous oxide‐based vs. nitrous oxide‐free general anaesthesia and accidental awareness in surgical patients: an abridged Cochrane systematic review

“…Of these 12 studies, six did not include an intervention or comparator relevant to this review , in five studies the depth of anaesthesia differed between study arms [ and two papers reported on the ENIGMA‐2 study , which did not measure AAGA. Through this process we identified 22 publications covering 15 RCTs for inclusion in the review .…”

“…One study , although included in the qualitative synthesis of this review, could not be included in the primary analysis as the number of participants in each group was not reported. Eleven studies included a single comparison of a study group with nitrous oxide and a group without nitrous oxide , whereas four studies included more than one comparison . These ‘multi‐arm’ studies, included four or three comparison groups.…”

“…These ‘multi‐arm’ studies, included four or three comparison groups. The anaesthetic agents used in the studies varied, with seven using propofol , three using sevoflurane , three using isoflurane and two using desflurane . One study left additional anaesthetic agents to the discretion of the anaesthetists .…”

“…One study left additional anaesthetic agents to the discretion of the anaesthetists . Concentrations of nitrous oxide used in the included studies also varied, with two studies using 50% , four studies 60% , one study 65% , one study 66% , two studies 67% ) and five studies 70% . The methods used by anaesthetists to monitor depth of anaesthesia varied considerably.…”

A Prospective, Randomized Controlled Trial of Conscious Sedation Using Propofol Combined With Inhaled Nitrous Oxide for Dental Treatment

“…8 Sukhani et al 30 examined eye opening and orientation in patients given general anesthesia that included propofol and nitrous oxide and found that there was a faster immediate recovery as compared with propofol alone. On the other hand, Lindekaer et al 31 showed that the addition of nitrous oxide to propofol-alfentanil anesthesia prolonged the early recovery period. In our study the recovery time required to return to an OAA/S score of 5 (R 1 ) was slightly longer in group N+P than in group P. However, because there was no difference in the time required to obtain a negative Romberg sign (R 2 ) between the groups, it is unlikely that nitrous oxide had a negative impact on recovery time.…”