Current Status of Nitrous Oxide Use in Operating Rooms of Turkey

Abstract

Objective: Investigating the justifications of nitrous oxide (N2O) use in Turkey's hospitals and usage trends during the last five years. Design: A cross-sectional study Setting: A total of 170 university hospitals, training and research hospitals, state hospitals and private hospitals in Turkey. Subjects: Clinical chiefs of 170 anesthesia departments Interventions: A survey was conducted. The Kruskal-Wallis, Mann-Whitney U, Kolmogorov-Smirnov, Chi-square and Fisher tests were performed. This trial was registered at Clinical Trials.gov (NCT04124562). Main outcome measure(s): Hospital type, frequency of N2O use, how many times general anesthesia was used in a month, number of cases N2O was used on the day of the study, the status of N2O use by anesthetists in the last five years, and the reasons for its use were questioned. Results: N2O use combined with inhaled anesthetics was reported by 119 (72.1%) clinical chiefs of anesthesia departments. The mean number of general anesthesia cases in one month in 165 (84.1%) clinics included in this study was reported to be 95,044. The number of cases using N2O combined with inhalational anesthetics was 1401 (39.6%) in one day. Regarding N2O usage in the last five years, 68 (41.2%) anesthetists responded that their usage rate had decreased, 48 (29.1%) stated that they had stopped using, and 47 (28.5%) anesthetists responded that their usage rate was unchanged. Stopping or reducing N2O use due to environmental or global climate and pollution concerns were observed more frequently in the operating rooms of the university hospitals (P<0.05). Conclusion: Despite a reduced usage rate of N2O in Turkey, it is still higher than that of European countries.