Why the study?
The effects of 30% low-concentration nitrous oxide anesthesia on anxiety, pain, vital signs, and the patient population that would benefit during cataract surgery were investigated.
Does 30% low-concentration nitrous oxide anesthesia reduce anxiety and pain in patients undergoing cataract surgery?
Does 30% low-concentration nitrous oxide anesthesia reduce anxiety and pain in patients undergoing cataract surgery?
Low-concentration nitrous oxide combined with local anesthesia significantly reduces intraoperative anxiety and pain during cataract surgery compared to local anesthesia alone.
Associated with reduced anxiety in cataract surgery; leaves open confirmation in randomized trials.
Purpose: We investigated the effects of 30% low-concentration nitrous oxide (N 2 O) anesthesia on anxiety, pain, and vital signs and the patient population that would benefit from low-concentration N 2 O anesthesia during cataract surgery. Patients and Methods: Sixty-three patients who underwent cataract surgery due to visual impairment from cataracts were included in this single-center retrospective cohort study conducted at the Ophthalmology Department of Shinseikai Toyama Hospital, Japan. Fifty eyes of 39 patients received a combination of local and N 2 O anesthesia (N 2 O group), and 30 eyes of 24 patients received local anesthesia without N 2 O anesthesia (Air group). The primary outcome measures were visual analogue scale (VAS) scores for patient anxiety, pain, and vital signs. The secondary outcome measures were the patient population. Results: The change in the VAS scores for anxiety and pain decreased significantly ( p = 0.002 and p = 0.014, respectively) in the N 2 O group (− 15.6 ± 22.9 and 12.4 ± 14.9, respectively) compared with that in the Air group (1.2 ± 20.6 and 24.2 ± 22.4, respectively). The systolic and diastolic blood pressure changes did not significantly differ between both groups ( p = 0.093 and p = 0.23, respectively). The change in heart rate decreased significantly ( p = 0.001) in the N 2 O group (− 4.8 ± 4.8 bpm) compared with that in the Air group (− 0.6 ± 5.8 bpm). Multivariate analyses demonstrated that the change in anxiety level in the N 2 O group correlated significantly with patient age ( p = 0.045) and preoperative VAS score for anxiety ( p = 0.0001), whereas the change in anxiety level in the Air group did not correlate with any factor. Conclusion: Low-concentration N 2 O anesthesia showed beneficial effects on intraoperative anxiety and pain during cataract surgery; this may aid the stabilization of intraoperative vital signs. Moreover, low-concentration N 2 O anesthesia during cataract surgery could benefit young patients and patients with high levels of preoperative anxiety. Keywords: cataract surgery, low-concentration nitrous oxide anesthesia, patient anxiety A Letter to the Editor has been published for this article . A Response to Letter by Dr SHUJA has been published for this article.
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Sasajima et al. (2022) studied this question.
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