TY - JOUR
T1 - L’association entre protoxyde d’azote et durée de séjour en salle de réveil
T2 - une étude observationnelle rétrospective
AU - Obeidat, Salameh Sameh
AU - Wongtangman, Karuna
AU - Blank, Michael
AU - Wachtendorf, Luca J.
AU - Hammer, Maximilian
AU - Schaefer, Maximilian S.
AU - Santer, Peter
AU - Eikermann, Matthias
AU - Sundar, Eswar
N1 - Funding Information:
Salameh Sameh Obeidat , Karuna Wongtangman , and Michael Blank contributed equally to this manuscript. Salameh Sameh Obeidat helped conceptualize the paper, performed the literature review, wrote the initial draft of manuscript, and read and approved the final manuscript. Karuna Wongtangman helped conceptualize the paper, analyzed data, wrote the initial draft of manuscript, and read and approved the final manuscript. Michael Blank helped analyze the data, reviewed the manuscript, edited and modified drafts, and read and approved the final manuscript. Luca J. Wachtendorf and Maximilian Hammer helped analyze the data, reviewed the manuscript, edited and modified drafts, and read and approved the final manuscript. Maximilian S. Schaefer and Peter Santer gave suggestions on data analysis, helped interpret the data, reviewed the manuscript, edited and modified drafts, and read and approved the final manuscript. Matthias Eikermann, helped conceptualize the paper, gave suggestions on data analysis, reviewed the manuscript, edited and modified drafts, and read and approved the final manuscript. He is the guarantor of the study and takes responsibility for all parts from conceptualization to publication. Eswar Sundar helped conceptualize the paper, reviewed the manuscript, edited and modified drafts, and read and approved the final manuscript. Matthias Eikermann has received research support from Merck not related to this manuscript. This study was supported by Jeffrey and Judith Buzen in an unrestricted grant to Matthias Eikermann. This submission was handled by Dr. Philip M. Jones, Deputy Editor-in-Chief, Canadian Journal of Anesthesia/Journal canadien d’anesthésie.
Publisher Copyright:
© 2021, Canadian Anesthesiologists' Society.
PY - 2021/11
Y1 - 2021/11
N2 - 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.
AB - 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.
KW - general anesthesia
KW - intraoperative antiemetics
KW - intraoperative nitrous oxide
KW - perioperative care
KW - postanesthesia care unit length of stay
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U2 - 10.1007/s12630-021-02067-2
DO - 10.1007/s12630-021-02067-2
M3 - Article
C2 - 34406608
AN - SCOPUS:85112767445
SN - 0832-610X
VL - 68
SP - 1630
EP - 1640
JO - Canadian Journal of Anesthesia
JF - Canadian Journal of Anesthesia
IS - 11
ER -