PEROPERATIVE NITROUS OXIDE DELAYS BOWEL FUNCTION AFTER COLONIC SURGERY

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Abstract
Forty patients scheduled for elective colonic surgery were allocated at random to receive either nitrous oxide or air during surgery. Preoperative management, surgery, parenteral therapy and postoperative analgesics were similar in both groups. Anaesthetic management included isoflurane, vecuronium by infusion and fentanyl 3 μg kg−1 h−1. The air group required a mean inspired isoflurane concentration of 0.8% (SD 0.3), whereas the nitrous oxide group required 0.4% (SD 0.2). No differences were found in duration of operation, blood loss, need for postoperative analgesia or postoperative nausea. Patients in the air group had less gas in the small bowel (P < 0.005) and in the large bowel (P < 0.001), and operating conditions were better than in the nitrous oxide group (P < 0.01). After operation, the air group had significantly earlier bowel function than the nitrous oxide group, with earlier passing of flatus (3.4 (1.2) vs 4.7 (1.4) days) (P < 0.05) and faeces (4.7 (1.5) vs 6.3 (2.2) days) (P < 0.05) and required a shorter postoperative hospital stay (10.0 (1.3) vs 7 7.7 (2.5) days) (P < 0.05)