L’association entre protoxyde d’azote et durée de séjour en salle de réveil: une étude observationnelle rétrospective

Translated title of the contribution: The association of nitrous oxide on length of stay in the postanesthesia care unit: a retrospective observational study

Salameh Sameh Obeidat, Karuna Wongtangman, Michael Blank, Luca J. Wachtendorf, Maximilian Hammer, Maximilian S. Schaefer, Peter Santer, Matthias Eikermann, Eswar Sundar

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Purpose: To assess whether intraoperative use of nitrous oxide (N2O) as an adjunct to general anesthesia is associated with a shorter length of stay in the postanesthesia care unit (PACU). Methods: We analyzed data from adult patients who underwent non-cardiothoracic surgery under general anesthesia between May 2008 and December 2018. We assessed the association between intraoperative low- and high-dose N2O and PACU length of stay. Results: A total of 148,284 patients were included in the primary analysis. After adjusting for a priori defined confounders, a high dose of N2O significantly decreased PACU length of stay, with a calculated difference of −9.1 min (95% confidence interval [CI], −10.5 to −7.7; P < 0.001). Patients who received high-dose N2O had a lower incidence of both short- and prolonged-duration of intraoperative hypotension (adjusted odds ratio [aOR], 0.85; 95% CI, 0.83 to 0.88; P < 0.001 and aOR, 0.76; 95% CI, 0.73 to 0.80; P < 0.001, respectively) and received a lower total intraoperative vasopressor dose (−0.04 mg of norepinephrine equivalents; 95% CI, −0.06 to −0.01; P = 0.01). The effect of high-dose N2O on PACU length of stay was modified by surgical complexity (adjusted absolute difference: −26.1 min; 95% CI, −29.2 to −23.1; P < 0.001; P for interaction < 0.001), and most pronounced in patients who underwent complex surgery and received intraoperative antiemetic therapy (adjusted absolute difference: −38.9 min; 95% CI, −43.1 to −34.6; P < 0.001; P for interaction < 0.001). Conclusions: Nitrous oxide was dose-dependently associated with a decreased PACU length of stay. The effect was clinically relevant (> 30 min difference) in patients who underwent complex surgical procedures and received intraoperative antiemetic therapy.

Translated title of the contributionThe association of nitrous oxide on length of stay in the postanesthesia care unit: a retrospective observational study
Original languageFrench
Pages (from-to)1630-1640
Number of pages11
JournalCanadian Journal of Anesthesia
Volume68
Issue number11
DOIs
StatePublished - Nov 2021

Keywords

  • general anesthesia
  • intraoperative antiemetics
  • intraoperative nitrous oxide
  • perioperative care
  • postanesthesia care unit length of stay

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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