The effect of nitrous oxide and carbon dioxide pneumoperitoneum on operative and postoperative pain during laparoscopic sterilization under local anesthesia.
OBJECTIVE
To compare carbon dioxide and nitrous oxide pneumoperitoneum with respect to intraoperative and postoperative pain during laparoscopic sterilization under local anesthesia.


METHODS
Randomized, double-blind study of pain during surgery and at 15 minutes, 1 hour, and 24 hours postoperatively.


METHODS
Regional Medical Center, Memphis, Tennessee.


METHODS
Women scheduled for laparoscopic sterilization under local anesthesia. Interventions. Forty-nine patients were randomized to carbon dioxide and 56 to nitrous oxide pneumoperitoneum.


RESULTS
Pain was assessed using a modified McGill pain questionnaire. Intraoperative pain was measured by the amount of supplemental narcotic required. Analgesic use in the recovery room and during the first 24 hours postoperatively was compared. Demographics for both groups were similar. The groups had no statistical differences in pain during surgery or at any of the postoperative time periods. Recovery room analgesia requirement was similar, but the nitrous oxide group used fewer pain tables (0.98 vs 0.42 tablets) in the first 24 hours.


CONCLUSIONS
There is no difference in intraoperative and postoperative pain between nitrous oxide and carbon dioxide pneumoperitoneum for laparoscopic sterilization when used in conjunction with a protocol such as ours.
Lipscomb
G H
GH
Department of Obstetrics and Gynecology, Room E-102, 853 Jefferson Avenue, Memphis, TN 38163, USA.
Summitt
R L
RL
McCord
M L
ML
Ling
F W
FW
D000284:Administration, Oral; D000328:Adult; D015760:Alfentanil / Q000008:administration & dosage / Q000627:therapeutic use; D000698:Analgesia; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use; D000772:Anesthesia, Local; D000779:Anesthetics, Local / Q000008:administration & dosage; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use; D002045:Bupivacaine / Q000008:administration & dosage; D002245:Carbon Dioxide / Q000009:adverse effects; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage / Q000627:therapeutic use; D007431:Intraoperative Complications; D010535:Laparoscopy / Q000009:adverse effects; D009609:Nitrous Oxide / Q000009:adverse effects; D010146:Pain / Q000209:etiology* / Q000517:prevention & control; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology* / Q000517:prevention & control; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects; D011997:Recovery Room; D013246:Sterilization, Tubal / Q000009:adverse effects; D013607:Tablets
D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D013607:Tablets; D002245:Carbon Dioxide; D015760:Alfentanil; D009609:Nitrous Oxide; D007052:Ibuprofen; D002045:Bupivacaine