RESUMO
PURPOSE: To investigate the effects in cataract surgery using local anesthesia along with a 30% low-concentration nitrous oxide (N2O) anesthesia compared with local anesthesia only. SETTING: Saneikai Tsukazaki Hospital. DESIGN: Retrospective, consecutive study. METHODS: Patients who underwent bilateral cataract surgery were enrolled. 37 patients using room air inhalation (Air group) and 45 patients using 30% low-concentration N2O anesthesia (70% oxygen, total 6 L/min) at surgery start (N2O group) were retrospectively reviewed. Systolic blood pressure (BPs), diastolic blood pressure (BPd), and heart rate (HR) at surgery start and end, and mean intraoperative oxygen saturation (% SpO2) were examined. Immediately following surgery, a questionnaire using the Visual Analog Scale score was done to determine intraoperative pain, anxiety, memory, and nausea. RESULTS: No systemic symptoms in all patients and ocular complications requiring treatment were observed. For the N2O and air groups, changes in BPs were -5.38 ± 11.07(P = .01) and 1.27 ± 13.61 mm Hg, and HR were -2.24 ± 6.76 and 0.89 ± 5.18 bpm (P = .001), respectively; intraoperative SpO2 was 99.05% ± 0.74% and 97.44% ± 1.31% (P < .001), intraoperative anxiety was 21.76 ± 23.2 and 37.17 ± 32.79 (P = .002), and intraoperative memory was 55.24 ± 36.8 and 68.91 ± 33.81 (P = .01), respectively. No patients experienced intraoperative nausea. There was no statistically difference in BPd (P = .47) and intraoperative pain (P = .62). CONCLUSIONS: Low-concentration N2O anesthesia may not cause respiratory depression, abnormal vital signs, or nausea in cataract surgery. It can suppress intraoperative anxiety and memory and decrease and stabilize vital signs.
Assuntos
Extração de Catarata , Catarata , Anestesia Geral , Humanos , Óxido Nitroso , Estudos RetrospectivosRESUMO
ABSTRACT: To evaluate the utility of low-concentration nitrous oxide (N2O) anesthesia in ptosis surgeryThis study was a retrospective consecutive case series that included 54 successive patients with blepharoptosis who underwent bilateral levator aponeurosis advancement and on whom skin resection performed by the same surgeon between August 2016 and July 2017. Among these patients, 27 were operated with a local anesthesia injection (air group) and 27 with a local anesthesia injection and low-concentration N2O anesthesia (N2O group). All N2O cases used a total of 6 L of gas comprising 70% oxygen and 30% N2O. Preoperative and postoperative blood pressure (BP) and heart rate (HR) and intraoperative pain, anxiety, nausea, and memory were measured immediately after surgery using visual analog scale score (VASS). Additionally, perioperative side effects were examined.There was no significant difference in age, sex, and preoperative and postoperative margin reflex distance (MRD) between the 2 groups (all Pâ>â.05). The intraoperative mean peripheral oxygen saturation was significantly higher (97.5%â±â1.6% vs 99.5%â±â.6%, Pâ<â.001), intraoperative HR was significantly lower (78.2â±â12.8 vs 70.7â±â11.6 bpm, Pâ=â.02), and operation time was significantly shorter (33.1â±â8.1 vs 29.4â±â10.3âminutes, Pâ=â.03) in the N2O group than in the air group.Difference between intraoperative and preoperative systolic BP (BPs) (+15.8â±â18.0 vs +â3.1â±â21.7 mm Hg, Pâ=â.02), diastolic BP (BPd) (+7.0â±â17.4 vs -2.3â±â13.6 mm Hg, Pâ=â.04), and HR (3.2â±â8.5 vs -3.9â±â9.4 bpm, Pâ=â.01) was significantly lower in the N2O group than in the air group.VASS of intraoperative pain was significantly lower in the N2O group than in the air group (49.5â±â24.7 vs 22.6â±â14.9, Pâ<â.001), whereas intraoperative anxiety and memory did not present significant differences between the groups (Pâ=â.09 and Pâ=â.45, respectively). Intraoperative nausea score was 0 for all cases in both groups. There was no other side effect.Ptosis surgery with anesthesia using 30% N2O may effectively suppress intraoperative BP and HR along with pain and shorten the operation time without side effects such as nausea.
