Document Detail

Intraoperative nitrous oxide as a preventive analgesic.
MedLine Citation:
PMID:  20865874     Owner:  NLM     Status:  MEDLINE    
Preventive analgesia is defined as the persistence of the analgesic effects of a drug beyond the clinical activity of the drug. The N-methyl D-aspartate receptor plays a critical role in the sensitisation of pain pathways induced by injury. Nitrous oxide inhibits excitatory N-methyl D-aspartate sensitive glutamate receptors. The objective of our study was to test the efficacy of nitrous oxide as a preventive analgesic. We conducted a retrospective analysis of data from a subset of patients (n = 100) randomly selected from a previous major multicentre randomised controlled trial on nitrous oxide (ENIGMA trial). Data analysed included postoperative analgesic requirements, pain scores and duration of patient-controlled analgesia during the first 72 postoperative hours. There was no significant difference in postoperative oral morphine equivalent usage (nitrous group 248 mg, no nitrous group 289 mg, mean difference -43 mg, 95% confidence interval 141 to 54 mg). However, patients who received nitrous oxide had a shorter duration of patient-controlled analgesia use (nitrous group 35 hours, no nitrous group 51 hours, mean difference -16 hours, 95% confidence interval -29 to -2 hours, P = 0.022). There was no difference in pain scores between the groups. The shorter patient-controlled analgesia duration in the nitrous oxide group suggests that intraoperative nitrous oxide may have a preventive analgesic effect.
D K Stiglitz; L N Amaratunge; A H Konstantatos; D E Lindholm
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Anaesthesia and intensive care     Volume:  38     ISSN:  0310-057X     ISO Abbreviation:  Anaesth Intensive Care     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-27     Completed Date:  2010-10-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0342017     Medline TA:  Anaesth Intensive Care     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  890-3     Citation Subset:  IM    
Department of Anaesthesia and Perioperative Medicine, The Alfred Hospital, Melbourne, Victoria, Australia.
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MeSH Terms
Aged, 80 and over
Analgesia, Patient-Controlled / methods
Analgesics, Non-Narcotic / pharmacology*
Analgesics, Opioid / administration & dosage,  therapeutic use
Double-Blind Method
Intraoperative Care / methods*
Middle Aged
Morphine / administration & dosage,  therapeutic use
Nitrous Oxide / pharmacology*
Pain Measurement
Pain, Postoperative / prevention & control*
Randomized Controlled Trials as Topic
Retrospective Studies
Young Adult
Reg. No./Substance:
0/Analgesics, Non-Narcotic; 0/Analgesics, Opioid; 10024-97-2/Nitrous Oxide; 57-27-2/Morphine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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