Current status of nitrous oxide use in operating rooms of Turkey

Demirkıran H., Tekeli A. E., YARDIMCI C., Korkutata Z., Keskin S., GÜLHAŞ N.

Kuwait Medical Journal, vol.55, no.4, pp.307-313, 2023 (SCI-Expanded) identifier

  • Publication Type: Article / Article
  • Volume: 55 Issue: 4
  • Publication Date: 2023
  • Journal Name: Kuwait Medical Journal
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.307-313
  • Keywords: environmental concerns, nitrous oxide, side effects, Turke
  • Yozgat Bozok University Affiliated: Yes


Objective: Investigating the justifications of nitrous oxide (N2 O) 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 (NCT04124562). Main outcome measure(s): Hospital type, frequency of N2 O use, how many times general anesthesia was used in a month, number of cases N2 O was used on the day of the study, the status of N2 O use by anesthetists in the last five years, and the reasons for its use were questioned. Results: N2 O 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 N2 O combined with inhalational anesthetics was 1401 (39.6%) in one day. Regarding N2 O 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 N2 O 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 N2 O in Turkey, it is still higher than that of European countries.