DOI: 10.36347/sjams.2019.v07i12.007

Pages: 3861-3863

Aim: The main objective of this trial was to evaluate, compare and Determine the incidence of PONV with intra-operative use of N2O (Nitrous Oxide) and Medical Air or General Anesthesia in patients undergoing Breast Surgery. Material and Method: 80 ASA 1 & 11 Female patients whose age > 18 years and admitred for Breast Surgery between April 2018 to June 2019 were included in this observational prospective study done a Katihar Medical college and Hospital, Katihar, Bihar. Patients were equally divided in 2 groups, in which Group A received oxygen & Medical Air (Fio2 0.4)(N=30) and Group B received oxygen & Nitrous oxide (Fio2 0.4) (N=30)]. Fentanyl (2 microgram/kg) and Propofol (1- 2 mg/kg) were induced in all patients and maintained with sevoflurane, 40% oxygen with air/N2O and vecuronium bromide (0.08mg/kg). All the patients were reversed with glycopyrrolate (0.02mg/kg) and Neostigmine (0.05mg/kg). As injection dexamethasone 4mg all the patients received PONV prophylaxis As per recent PONV guideline at the start of surgery and also at the end of surgery they received injection ondansetron 4mg iv. All patients also received injection diclofenac 1.5mg/kg dosing at the end of the surgery and repeated 8hrly in the post-operative period. When pain score goes above 4 on NRS or as per demand, paracetamol 15mg/kg iv was given as rescue analgesia. PONV was recorded in periodic interval which consists of 1st hr, 6hr and 12hr post operatively. Result: In Group A incidence of PONV was only 3.3% where as it was 26.4 % in Group B with a p value of <0.023. At 6 hr the same was 0 in Group A whereas it was 20% in Group B with a p value of <0.023. At 12 hr. hr the same was 1 in Group A whereas it was 14 in Group B with a p value of <0.0002. Dose of paracetamol was comparable in both the groups. Conclusion: PONV incidence was significantly less in group A which consists of Medical Air as compare to Group B which consists of Nitrous Oxide.