This video discusses the use of low-concentration nitrous oxide (N₂O) anesthesia in combination with local anesthesia in ophthalmic surgery. Ptosis, cataract, and vitreoretinal surgery patients with normal local anesthesia and N₂O were retrospectively analyzed in terms of vital change, operation feeling, and intraocular pressure (IOP). The effectiveness of N₂O in pediatric surgery, as well as for patients with dementia, claustrophobia, and tremors, was also investigated. Results showed that the increase in blood pressure and heart rate of patients in the N₂O group was significantly suppressed (all P < .05). Pain and anxiety and intraoperative memory were also suppressed in patients in the N₂O group. It was observed that N₂O suppressed severe claustrophobia, body movement, and nystagmus, and eliminated tremors in children. The increase in IOP with N₂O during gas replacement surgery was not significantly different from that without N₂O use. No other side effects were noted. Overall, N₂O was found to stabilize vital signs and several intraoperative symptoms without side effects.

Financial Disclosures: Drs. Santaro Noguchi and Asuka Noguchi disclose no financial relationships.