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KMID : 0390219990100010036
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Journal of Clinical Otolaryngology, Head and Neck Surgery
1999 Volume.10 No. 1 p.36 ~ p.40
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The Influence of Nitrous Oxide on the Middle Ear Effusion
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이상흠/Sang Heum Lee
김진홍/조승배/윤성희/심재현/이동명/Jin Hong Kim/Sung Bae Cho/Sung Hee Yun/Jae Hyun Sim/Dong Myung Lee
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Abstract
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Background and Objectives: The nitrous oxide (N2O) is a widely used
anesthetic gas and has been known to increases middle ear pressure during anesthesia.
The positive pressure induced by the nitrous oxide may be sufficient to open the
eustachian tube and to evacuate the fluid from the middle ear. In this study, we
attempted to evaluate the influence of N2O on the patients with middle ear
effusion. We assumed that N2O increased the middle ear pressure to
evacuate the fluid from the middle ear. On the other hand, other anesthetic agents
might not influence the middle ear pressure to evacuate the fluid from the middle ear
cavity. Materials and Method: We reported 243 operated ears (175 patients) who
underwent myringotomy and ventilation tube insertion from January 1995 to March 1998
in Daedong Hospital. We evaluated their type of anesthesia, impedance audiometry
findings, microscopic findings of the tympanic membrane during surgery, concomitant
nasal symptom, rate of recurrence. Results: The percentage of absence of fluid during
surgery, was higher in the group of anesthesia with N2O than that of
without N2O. Patients who underwent anesthesia with N2O
showed 31.1% disappearance rate of the fluid, whereas, patients without
N2O anesthesia showed only 5.6% disappearance rate. The number of
patients who had middle ear effusion with concomitant nasal symptoms were 125
patients. Patients who underwent anesthesia with N2O showed 38.5%
disappearance rate of the fluid whereas, patients without N2O anesthesia
showed only 5.0% disappearance rate. Conclusion: Anesthesia with nitrous oxide showed
a great tendency of disappearance of middle ear effusion than without nitrous oxide.
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