This approach has been design ed to provide adequate analgesia while minimizing exposure to adverse events
Background : Laparoscopic cholecystectomy has advantages over the open procedure for postoperative pain .
However , a systematic review of postoperative pain management in this procedure has not been conducted .
Anesthesia for laparoscopic cholecystectomy. Is nitrous oxide contraindicated?
Since it has been suggested that the use of nitrous oxide ( N2O ) may contribute to bowel distention , we evaluated the effects of N2O on operating conditions during laparoscopic cholecystectomy in 50 healthy patients using a double-blind protocol design . All patients received the same preanesthetic medication ( midazolam , 2 mg intravenously ) and induction of anesthesia consisted of intravenously administered fentanyl 1.5 micrograms.kg-1 , thiopental 4 - 6 mg.kg-1 , and a nondepolarizing muscle relaxant . For maintenance of anesthesia , patients were r and omly assigned to one of two treatment groups : group 1 ( n = 26 ) received isoflurane with 70 % N2O in oxygen ( O2 ) , whereas group 2 ( n = 24 ) received isoflurane in an air/O2 mixture . The surgeon ( blinded to the anesthetic technique ) estimated the degree of technical difficulty before beginning the operation using a five-point scale . At 15-min intervals throughout the operation , the surgeon was asked to evaluate both " overall operating conditions " and degree of " bowel distension " using independent five-point scales . At the end of the operation , the surgeon was asked whether or not N2O had been used as part of the anesthetic technique . There were no significant intraoperative differences between the two groups with respect to operating conditions or bowel distension . More importantly , there was no time-related change in either variable during the course of the operation . Finally , the incidence of postoperative nausea and vomiting was similar in both treatment groups . The surgeon was able to correctly determine that N2O had been administered only 44 % of the time . Thus , N2O had no clinical ly apparent deleterious effects during laparoscopic cholecystectomy
This approach has been design ed to provide adequate analgesia while minimizing exposure to adverse events
Background : Laparoscopic cholecystectomy has advantages over the open procedure for postoperative pain .
However , a systematic review of postoperative pain management in this procedure has not been conducted .