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RetinaDecember 20242 citations

INTRAOCULAR PRESSURE AND SAFETY OF VITRECTOMY WITH VITREOUS GAS REPLACEMENT USING LOW-CONCENTRATION NITROUS OXIDE GAS ANESTHESIA.

Noguchi Santaro, Nakakura Shunsuke, Noguchi Asuka, Tabuchi Hitoshi


AI Summary

Low-concentration nitrous oxide anesthesia for vitrectomy with fluid-air exchange safely reduced pain and stabilized vital signs without increasing IOP, offering a viable alternative to local anesthesia.

Abstract

Purpose

The aim of this study is to evaluate the efficacy and safety of vitrectomy with vitreous gas replacement using low-concentration nitrous oxide (N 2 O) gas anesthesia, focusing on intraocular pressure (IOP) changes, pain, anxiety, and safety outcomes.

Methods

This retrospective study analyzed 133 patients undergoing fluid-air exchange without use of SF6 or C3F8, at Saneikai Tsukazaki Hospital, Japan, from April 2019 to March 2022. Participants were divided into two groups: those receiving low-concentration nitrous oxide gas anesthesia (N 2 O group) and those receiving local anesthesia with room air inhalation (air group). IOP, pain, anxiety levels, and intraoperative complications were assessed.

Results

No significant differences were found in IOP changes postoperatively between the N 2 O and air groups. The N 2 O group reported significantly lower pain scores and had lower intraoperative systolic blood pressure and heart rate changes compared with the air group. No significant intraoperative or postoperative complications were observed in either group.

Conclusion

Vitrectomy with fluid-air exchange using low-concentration nitrous oxide gas anesthesia is safe, does not increase IOP, and may offer benefits in reducing intraoperative pain and stabilizing vital signs compared with traditional local anesthesia methods. This approach could be considered a viable option for vitreous surgery requiring fluid-air exchange.


MeSH Terms

HumansVitrectomyNitrous OxideMaleFemaleIntraocular PressureRetrospective StudiesMiddle AgedVitreous BodyAgedAnesthetics, InhalationEndotamponadeAdultFollow-Up Studies

Key Concepts5

Vitrectomy with fluid-air exchange using low-concentration nitrous oxide gas anesthesia did not show significant differences in postoperative intraocular pressure (IOP) changes compared to local anesthesia with room air inhalation in 133 patients.

Comparative EffectivenessCohortRetrospective Cohort Studyn=133 patientsCh3Ch28

Low-concentration nitrous oxide gas anesthesia for vitrectomy with fluid-air exchange resulted in significantly lower pain scores compared to local anesthesia with room air inhalation in 133 patients.

Comparative EffectivenessCohortRetrospective Cohort Studyn=133 patientsCh28

Low-concentration nitrous oxide gas anesthesia for vitrectomy with fluid-air exchange led to lower intraoperative systolic blood pressure and heart rate changes compared with local anesthesia with room air inhalation in 133 patients.

Comparative EffectivenessCohortRetrospective Cohort Studyn=133 patientsCh28

No significant intraoperative or postoperative complications were observed in either the low-concentration nitrous oxide gas anesthesia group or the local anesthesia with room air inhalation group during vitrectomy with fluid-air exchange in 133 patients.

TreatmentCohortRetrospective Cohort Studyn=133 patientsCh28

A retrospective study analyzed 133 patients undergoing fluid-air exchange without the use of SF6 or C3F8 at Saneikai Tsukazaki Hospital, Japan, from April 2019 to March 2022, comparing low-concentration nitrous oxide gas anesthesia to local anesthesia with room air inhalation.

MethodologyCohortRetrospective Cohort Studyn=133 patientsCh28

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