Postoperative nitrous oxide analgesia and the functional residual capacity

Surgery of the upper abdomen is associated with the greatest demand for postoperative analgesia and also is marked by depressed pulmonary function, arterial hypoxemia, and pulmonary complications. Nitrous oxide (N2O) in concentrations of 15-25% is a potent analgesic and is relatively free of untoward side effects if administered for a maximum of 48 h. In the present study, the effect of N2O analgesia on postoperative lung function, in particular, the functional residual capacity (FRC), is examined. Eighteen cholecystectomy patients received either a narcotic (N = 11) or N2O (N = 7) for postoperative analgesia. N2O-treated patients had satisfactory analgesia and maintained FRC at normal levels. Narcotic treated patients had a fall of 22% in FRC. N2O had no effect on the formed elements in peripheral blood.