Pain reports · 2026
Randomized trial of intraoperative nitrous oxide for postoperative pain reduction in cervical spinal cord injury.
СтатьяНазвание и аннотация: Перевод в очереди
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Hoshina Mayu, Kato Takao, Shiko Yuki, Kawasaki Yohei, Okubo Kunihide, Kimura Akiko, Yokotani Madoka, Mazda Yusuke, Yahata Tadashi, Inokuchi Koichi, Obata Hideaki
Аннотация
INTRODUCTION: Neuropathic pain after cervical spinal cord injury (SCI) is common and difficult to manage.
OBJECTIVES: To evaluate whether intraoperative nitrous oxide (N2O) influences acute postoperative pain and long-term neuropathic pain after cervical SCI surgery.
METHODS: This single-center, randomized study enrolled adults (≥20 yr) undergoing emergency surgery for traumatic cervical SCI (American Spinal Injury Association Impairment Scale C or D). Patients were randomly assigned to receive intraoperative N2O or Air. The primary outcome was resting pain intensity on postoperative day 1 (D1), measured using the Numeric Rating Scale (NRS). Secondary outcomes included global pain and neuropathic pain assessments up to 6 months (6M) after surgery.
RESULTS: Of 80 randomized patients, 59 were analyzed (mean [SD] age 70.34 [12.07] years; 46 [78%] male). Baseline characteristics were similar between groups (Air, n = 29; N2O, n = 30). The primary outcome was higher in the N2O group, indicating no acute analgesic effect (NRS on D1: 3.27 [2.69] vs 5.10 [3.06]; P = 0.021). By contrast, at 6M, resting NRS was lower in the N2O group (1.72 [2.64] vs 0.53 [1.25]; P = 0.030), and numbness-related symptoms also improved. No serious adverse events occurred.
CONCLUSION: Intraoperative N2O did not reduce acute postoperative pain after cervical SCI surgery. However, exploratory secondary analyses suggested a potential reduction in chronic neuropathic pain at 6 months, supporting the hypothesis that early perioperative modulation of central sensitization may influence pain chronification after SCI.
OBJECTIVES: To evaluate whether intraoperative nitrous oxide (N2O) influences acute postoperative pain and long-term neuropathic pain after cervical SCI surgery.
METHODS: This single-center, randomized study enrolled adults (≥20 yr) undergoing emergency surgery for traumatic cervical SCI (American Spinal Injury Association Impairment Scale C or D). Patients were randomly assigned to receive intraoperative N2O or Air. The primary outcome was resting pain intensity on postoperative day 1 (D1), measured using the Numeric Rating Scale (NRS). Secondary outcomes included global pain and neuropathic pain assessments up to 6 months (6M) after surgery.
RESULTS: Of 80 randomized patients, 59 were analyzed (mean [SD] age 70.34 [12.07] years; 46 [78%] male). Baseline characteristics were similar between groups (Air, n = 29; N2O, n = 30). The primary outcome was higher in the N2O group, indicating no acute analgesic effect (NRS on D1: 3.27 [2.69] vs 5.10 [3.06]; P = 0.021). By contrast, at 6M, resting NRS was lower in the N2O group (1.72 [2.64] vs 0.53 [1.25]; P = 0.030), and numbness-related symptoms also improved. No serious adverse events occurred.
CONCLUSION: Intraoperative N2O did not reduce acute postoperative pain after cervical SCI surgery. However, exploratory secondary analyses suggested a potential reduction in chronic neuropathic pain at 6 months, supporting the hypothesis that early perioperative modulation of central sensitization may influence pain chronification after SCI.