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

Mehtap Ozdemir, Nurten Bakan, Murat Haliloglu, Yonca Yanli, Nevin Kurt Celebi, Zeynel Abidin Erbesler, Tulin Yollu

Mehtap Ozdemir, Nurten Bakan, Murat Haliloglu, Yonca Yanli, Nevin Kurt Celebi, Zeynel Abidin Erbesler, Tulin Yollu, The Effects Of Nitrous Oxide On Postoperative Pain, Nausea Vomiting and Intraoperative Haemodynamics in Robotic Gynecologic Surgery(2017)SDRP Journal of Anesthesia & Surgery 2(2)

BACKGROUND:

In recent years there has been an increase in gynaecological operations performed with robotic surgery. In these procedures, nitrous oxide(N₂O) or air are used together with inhalation anaesthestics. In this study we aimed to compare the effects of O₂/N₂O or O₂/Air on postoperative pain, nausea vomiting (PONV) and intraoperative haemodynamics in robotic surgery.

METHODS:

Aged 28-71 years, classified ASA I-II, 58 patients were separated into 2 groups. Following induction, anaesthesia was maintained O₂/Air (Group A) or O₂/N₂O (Group N) with sevoflurane. Heart rate (HR), mean arterial pressure (MAP), Central Venous Pressure (CVP), end tidal carbon dioxide (ETCO₂), peripheral oxygen saturation (SpO₂), Aldrete recovery score (ARS), postoperative nausea and vomiting (PONV) and visual analog scale (VAS) were recorded during the operation and postoperative period.

RESULTS:

The 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 Group A (p<0.05).

CONCLUSION:

 With regard to acute postoperative analgesia we could not find any significant difference between N₂O 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.

Keywords: Robotic surgery, Nitrous oxit, General anesthesia, Visual analog scale, Postoperative nausea vomiting

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