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Chronic postsurgical pain after nitrous oxide anesthesia.

Matthew T V Chan1, Alex C M Wan, Tony Gin

  • 1Department of Anaesthesia and Intensive Care, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Melbourne, Australia Department of Pharmacology, University of Melbourne, Melbourne, Australia Department of Anaesthesia and Perioperative Medicine, Alfred Hospital, Melbourne, Australia Academic Board of Anaesthesia and Perioperative Medicine, Monash University, Melbourne, Australia.

Pain
|September 6, 2011
PubMed
Summary
This summary is machine-generated.

Intraoperative nitrous oxide administration may reduce the risk of chronic postsurgical pain. This follow-up study found that nitrous oxide decreased the likelihood of persistent pain after major surgery.

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Area of Science:

  • Anesthesiology
  • Pain Medicine
  • Surgical Research

Background:

  • Chronic postsurgical pain is a significant complication after major surgery.
  • Nitrous oxide's antagonism of the N-methyl-D-aspartate receptor suggests a potential role in preventing chronic pain.

Purpose of the Study:

  • To evaluate the preventive analgesic efficacy of intraoperative nitrous oxide in reducing chronic postsurgical pain.
  • To assess the impact of chronic pain on quality of life in surgical patients.

Main Methods:

  • Follow-up study of patients from the randomized controlled Evaluation of Nitrous Oxide in the Gas Mixture for Anaesthesia (ENIGMA) trial.
  • Structured telephone interviews using the modified Brief Pain Inventory to assess chronic pain (≥3 months duration).
  • Analysis of pain intensity, analgesic requirements, and quality of life.

Main Results:

  • 10.9% of patients reported chronic pain persisting from the index surgery; 9.2% had severe pain.
  • Patients with chronic pain reported significantly lower quality of life.
  • Multivariate analysis indicated nitrous oxide decreased the risk of chronic postsurgical pain.

Conclusions:

  • Chronic postsurgical pain is a common outcome following major noncardiac surgery.
  • Intraoperative administration of nitrous oxide was associated with a reduced incidence of chronic postsurgical pain.
  • Early postoperative pain, wound complications, and abdominal incisions were risk factors for developing chronic pain.