Lowerandmiddleureter URS_Vibrolith P224.pdfVIP

222 labyrinth and vestibule via round window1. In our series right and left middle ear pressure values were significantly different in cases with nausea and vomiting that’s why we concluded that difference in middle ear pressures of right and left ear causes nausea and vomiting. As a result, N2O use seems to be inappropriate for brief operations because it inceases MEP. However, in long term operations N2O used with remifentanil has no effect on MEP as well as on nausea and vomiting. Difference between right and left MEP values is an important factor increasing nausea and vomiting frequency and this should be further supported by future studies with larger sample size. REFERENCES 1. Simpson G, Reedy RL. Middle ear pressure changes after nitrous oxide anesthesia and its effect on postoperative nausea and vomiting. Laryngoscope 2004;114: 883-6. 2. Perreault L, Normandin N, Plamondon L. Tympanic membrane rupture after anesthesia with nitrous oxide. Anesthesiology 1982;57: 325-6. 3. White PF. Spontaneous rupture of tympanic membrane occurring in the absence of middle ear disease. Anesthesiology 1983;59: 368-9. 4. Golembiewski J, Chernin E, Chopra T. Prevention and treatment of postoperative nausea and vomiting. American Journal of Health-System Pharmacy 2005; 62: 1247-61. 5. Palazzo MGA, Strunin L. Anaesthesia and emesis. I: Etiology. Can Anaesth Soc J 1984; 31: 178-87. 6. Armstrong HG, Heim JW. The effect of flight on the middle ear. JAMA 1937;109: 417-21. 7. Koivunen P, Alho OP, Uhari, M, Partanen, A, Luotonen, J. General anesthesia with and without nitrous oxide (N2O) and the weight of middle ear effusion in children undergoing adenoidectomy and tympanostomy. Laryngoscope 1996; 106: 724-6. 8. Kubota T, Kazuyoshi H, Noriaki O, Tadanobu Y, Akimasa M, Asahai M, et al. Middle-ear pressure variations during total intravenous anesthesia with propofol, fentanyl, and ketamine. J Anesth 1998;12: 17-20. 9. Thomsen KA, Terkilds