Abstract
The aim of this study was to establish whether nitrous oxide has a clinically important effect on postoperative vomiting in children after myringotomy. We studied 320 healthy children of ages 0.5–13 yr undergoing elective myringotomy and tube insertion. Induction and maintenance of anaesthesia were randomized to inhalation with either 70% N2O/30% O2/halothane or 100%O2/halothane. Surgical technique and postoperative management were not influenced by this study. Vomiting in the recovery room (PAR) and Day Care Surgical Unit (DCSU) was recorded by nurses unaware of the anaesthetic technique. Parents were contacted 24–48 hr after surgery to ascertain the incidence of vomiting after discharge. The groups were similar with respect to demographic data, except that the anaesthesia time was greater among the 158 patients in the N2Otreated group (11 ± 4 vs 12 ± 4 min, mean ± SD. The incidence of vomiting was 13% in both groups. Most of the 42 patients that had emesis only vomited once or twice. The incidence of vomiting was not altered by sex (13% vs 13%) or duration of anaesthesia. The incidence of vomiting increased with increasing age. The children aged less than 3 yr vomited 4% of the time, those aged 3–5 vomited 11% of the time, those aged 6–8 yr vomited 17% of the time, while the incidence of vomiting among those aged 9–13 yr was 31% Vomiting prolonged the postoperative hospital stay from 75 to 92 min, P < 0.001, ANOVA. In summary, we have been unable to demonstrate that N2O induces vomiting by children after a brief general anaesthetic for myringotomy.
Résumé
Cette étude a pour but d’établir si le protoxyde d’azote des vomissements chez les enfants après une myringotomie. L’étude porte sur 320 enfants bien portants âgés de 0,5 à 13 ans soumis à une myringotomie programmée avec insertion de tube. L’induction et l’entretien de l’anesthésie sont randomisés pour l’inhalation soit de N2O 70%/O2 30% avec halothane, soit d’O2 100% avec halothane. Cette étude n’influence ni la technique chirurgicale ni la gestion postopératoire. Les vomissements à la salle de réveil et à l’unité chirurgicale de jour sont enregistrés par des infirmières ignorant la technique utilisée. Les parents sont contactés 24–48 après la chirurgie pour évaluer l’incidence des vomissements. Les groupes sont comparables au regard des données démographiques, à l’exception du fait que la durée de l’anesthésie est plus grande dans le groupe N2O (moyenne ± SD: 11 ± 4 vs 12 ± 4. L’incidence des vomissements n’est modifiée ni par le sexe (13% vs 13%) ni la durée de l’anesthésie. L’incidence des vomissements augmente avec l’âge. Les enfants de moins de trois ans vomissent 4% du temps, ceux de 3–5 ans vomissent 11% du temps, alors que l’incidence des vomissements est de 31% chez les enfants de 9–13 ans. Les vomissements prolongent la durée du séjour hospitaller de 75 à 92 min, P < 0,001 (ANOVA). En résumé, nous n’avons pu démontrer que le N2O provoque des vomissements après la courte anesthésie générale administrée pour la myringotomie.
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Splinter, W.M., Roberts, D.J., Rhine, E.J. et al. Nitrous oxide does not increase vomiting in children after myringotomy. Can J Anaesth 42, 274–276 (1995). https://doi.org/10.1007/BF03010701
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DOI: https://doi.org/10.1007/BF03010701