N2O通过类似药物的作用，在开放手术中强有力地防止粘连形成和术后疼痛。

Q2 Medicine Gynecological Surgery Pub Date : 2017-01-01 Epub Date: 2017-11-07 DOI:10.1186/s10397-017-1024-2

Roberta Corona, Maria Mercedes Binda, Leila Adamyan, Victor Gomel, Philippe R Koninckx

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引用次数: 2

摘要

背景:显微外科原则和腹腔镜手术(LS)期间腹膜调节减少术后粘连和疼痛。对于人体试验，N2O的强大有益作用需要在开放手术(OS)中得到证实。结果:在小鼠骨肉瘤模型中，评估了气体环境对粘连的影响。实验1评估了干燥和暴露于CO2、N2O或CO2 + 4%O2的持续时间。实验二评价了向CO2中添加N2O的量效曲线。实验三比较了湿化CO2 + 10% N2O在LS和OS中的作用。在OS中，暴露于未加湿的二氧化碳30分钟和60分钟分别导致33%和100%的死亡率。湿化、干燥的N2O或干燥的CO2 + 4%O2可防止死亡。黏附随暴露于CO2的时间延长而增加(p 2)。N2O浓度在5%或更高时，能显著降低黏附。当加湿CO2 + 10% N2O时，OS和LS的粘附形成相似。结论:低浓度N2O对OS具有类似药物的强有益作用。

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N₂O strongly prevents adhesion formation and postoperative pain in open surgery through a drug-like effect.

Background: Microsurgical tenets and peritoneal conditioning during laparoscopic surgery (LS) decrease postoperative adhesions and pain. For a trial in human, the strong beneficial effects of N₂O needed to be confirmed in open surgery (OS).

Results: In a mouse model for OS, the effect of the gas environment upon adhesions was evaluated. Experiment I evaluated desiccation and the duration of exposure to CO₂, N₂O or CO₂ + 4%O₂. Experiment II evaluated the dose-response curve of adding N₂O to CO₂. Experiment III compared humidified CO₂ + 10% N₂O during LS and OS.In OS, 30- and 60-min exposure to non-humidified CO₂ caused mortality of 33 and 100%, respectively. Mortality was prevented by humidification, by dry N₂O or dry CO₂ + 4%O₂. Adhesions increased with the duration of exposure to CO₂ (p < 0.0001) and decreased slightly by humidification or by the addition of 4% O₂. N₂O strongly decreased adhesions at concentrations of 5% or greater. With humidified CO₂ + 10% N₂O, adhesion formation was similar in OS and LS.

Conclusions: The drug-like and strong beneficial effect of low concentrations of N₂O is confirmed in OS.

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来源期刊

Gynecological Surgery SURGERY-

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期刊介绍： "Gynecological Surgery", founded in 2004, is the first and premier peer-reviewed scientific journal dedicated to all aspects of research, development, and training in gynecological surgery. This field is rapidly changing in response to new developments and innovations in endoscopy, robotics, imaging and other interventional procedures. Gynecological surgery is also expanding and now encompasses all surgical interventions pertaining to women health, including oncology, urogynecology and fetal surgery. The Journal publishes Original Research, Reviews, Evidence-based Viewpoints on clinical protocols and procedures, Editorials, Perspectives, Communications and Case Reports.