Nitrous oxide and laparoscopic bariatric surgery.

Author: Brodsky JB, Lemmens HJ, Collins JS, Morton JM, Curet MJ, Brock-Utne JG

Author affiliation: Department of Anesthesia, Stanford University School of Medicine, Stanford, CA 94305, USA. Jbrodsky@stanford.edu

Publication date & source: 2005.04, Obes Surg., 15(4):494-6.

Publication type: Clinical Trial; Comparative Study ; Randomized Controlled Trial

BACKGROUND: Nitrous oxide (N2O) is frequently used to supplement more potent anesthetic agents. One side-effect of N2O is its ability to expand an air-containing space. We investigated if N2O adversely affected operating conditions by distending normal bowel during laparoscopic bariatric procedures. METHODS: 50 morbidly obese patients were divided into 2 study groups. Group 1 patients were ventilated with a halogenated anesthetic/oxygen/air mixture, while Group 2 received a halogenated anesthetic/oxygen/N2O mixture. At 30, 60, and 90 min intervals during the operation, the surgeon was asked if N2O was being used. RESULTS: The surgeons responded correctly only 42% (30 min), 50% (60 min), and 48% (90 min) of the time. In Group 2 (N2O) patients, they incorrectly answered that N2O was not being used 88% (30 min), 68% (60 min), and 68% (90 min); and in Group 1 (air) patients, they incorrectly answered that N2O was being used 28% (30 min), 32% (60 min), and 36% (90 min) of the time. CONCLUSION: We found that using N2O did not cause noticeable bowel distention during laparoscopic bariatric procedures of relatively short duration.