Navigation Links
Using nitrous oxide for anesthesia doesn't increase -- and may decrease -- complications and death
Date:4/21/2013

San Francisco, CA. (April 22, 2013) Giving nitrous oxide as part of general anesthesia for noncardiac surgery doesn't increase the rate of complications and deathand might even decrease the risk of such events, according to a pair of studies in the May issue of Anesthesia & Analgesia, official journal of the International Anesthesia Research Society (IARS).

But an accompanying series of editorials points out some important limitations of the two studieswhich can't completely overcome previous concerns about the safety of using nitrous oxide (N2O) as a surgical anesthetic.

Is Nitrous Oxide Safe for Surgical Anesthesia?

Nitrous oxide is the world's oldest general anesthetic, but there's a long history of debate regarding its appropriate role in modern surgical anesthesia. Although nitrous oxide provides effective sedation and pain control, it has known disadvantages and side effects. A previous study, called "ENIGMA-I," reported a small but significant increase in myocardial infarction (heart attack) among patients receiving nitrous oxide as part of anesthesia for noncardiac surgery (procedures other than heart surgery).

The two new studies, based on large patient databases, question the harmful effects of nitrous oxide. Dr Kate Leslie of Royal Melbourne Hospital, Australia, and colleagues analyzed data from a previous study of more than 8,300 patients undergoing surgery. That study was designed to assess the effects of giving one type of blood pressure drug (beta-blockers) during surgery, not the effects of nitrous oxide.

Dr Leslie and colleagues compared the risk of death or serious complications after surgery for patients who versus did not receive nitrous oxide as part of anesthesia. Twenty-nine percent of patients in the study received nitrous oxide.

The results showed comparable rates of adverse outcomes between groups. With or without nitrous oxide, the overall rate of death or serious complications was approximately seven percent, including about a six percent rate of myocardial infarction. Risk of death after surgery was about three percent in both groups.

Outcomes remained similar on "propensity score" analysisa technique accounting for characteristics making patients more or less likely to receive nitrous oxide. Use of nitrous oxide varied widely between the different countries and hospitals participating in the study.

No Increase in Risks with N2OBut 'More Definitive' Studies Needed

Dr Alparslan Turan of the Cleveland Clinic and colleagues outcomes reviewed more than 49,000 patients undergoing noncardiac surgery between 2005 and 2009. In this study, 45 percent of patients received nitrous oxide.

The results suggested a significant reduction in the risk of death after surgery for patients receiving nitrous oxide: about one-third lower than in patients who did not receive nitrous oxide. There was also a significant 17 percent reduction in the combined rate of major complications and death.

Surprisingly, nitrous oxide was specifically associated with a 40 percent reduction in the risk of major lung- and breathing-related complications. However, the authors acknowledge the risk of "selection bias"anesthesiologists may have avoided using nitrous oxide in patients at risk of lung problems. Again, the findings remained significant on propensity score analysis.

In one of three accompanying editorials, Thomas R. Vetter, MD, MPH, and Gerald McGwin, Jr, MS, PhD, of University of Alabama at Birmingham highlight some important limitations of the study data. They note that, although both studies were large, they were not randomized trialsthe strongest type of scientific evidence.

Drs Vetter and McGwin emphasize that even sophisticated techniques like propensity score analysis can't account for all of the differences between groups that may have affected responses to nitrous oxide. They note that a randomized "ENIGMA-II" study is underway, and may provide "additional, perhaps more definitive insight" on the risks and potential benefits of using nitrous oxide as part of general anesthesia.


'/>"/>

Contact: Lisa Webb
lisa.webb@wolterskluwer.com
215-521-8319
Wolters Kluwer Health
Source:Eurekalert

Related medicine news :

1. Encinitas, CA Periodontist, Dr. Ann Mineo Kania Now Treats Patients with Periodontal Disease Using the Only FDA-Cleared Laser Gum Surgery for Gum Disease Treatment
2. 2 landmark studies report on success of using image-guided brachytherapy to treat cervical cancer
3. Career Confidential’s Finding a Job Fast Using a 30-60-90 Day Plan is now on Amazon
4. Smoking Bans in Public Housing Could Save Dollars, Lives: CDC
5. A New Peer-Reviewed Study Using CogniFit Brain Training Provides A Breakthrough In The Treatment Of Insomnia
6. Student Wins Grand Prize Using ATP Rapid Hygiene Monitoring System from Kaivac
7. Complete H2O Minerals Has Developed a Product for Women Using the Benefits of Liquid Vitamins and Minerals
8. More Health Care Professionals Abusing Anesthesia Drug: Study
9. Consumers Warehouse Center, Inc. Saves Time Using the Latest NOVAtime NetSuite Integration Bundle
10. Moffitt Cancer Center researchers design small molecule to disrupt cancer-causing protein
11. Duke University to Measure Altitude Sickness on Mount Everest Using MobileDemand Rugged Tablet PC
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/26/2016)... ... May 26, 2016 , ... Dr. ... Foundation Fighting Blindness, Long Island Chapter on June 4, 2016, 1:30-3:30 pm at ... Maisel, founder of Retina Group of New York , is a Board ...
(Date:5/26/2016)... ... May 26, 2016 , ... ... comprehensive treatment for eating disorders, is opening a brand new child and adolescent ... ages 8-17 and their families with even more specialized eating disorder treatment and ...
(Date:5/26/2016)... ... May 26, 2016 , ... The MIAMI Institute for Age Management and ... Adonis Maiquez MD, ABAARM. Dr. Adonis , Wellness Physician of the MIAMI Institute ... of the Institute for Functional Medicine. , He also heads up FITTLab, the comprehensive ...
(Date:5/26/2016)... ... ... On May 23rd during the National Eye Institute’s “Healthy Vision Month”, Sharon ... honored by Ashram, Inc. as the world’s foremost water visionary. , “Sharon Kleyne is ... the Nile to fill their red clay pots with life-sustaining water.” Said Ashram co-founder ...
(Date:5/26/2016)... ... 2016 , ... Saint Francis Hospital & Medical Center has ... have paid off. Since implementation of these efforts, surgical errors and readmissions ... patient experiences and reduce costly complications. Since implementation in 2011, safety efforts have: ...
Breaking Medicine News(10 mins):
(Date:5/25/2016)... GERMANTOWN, Maryland , May 25, 2016 /PRNewswire/ ... Frankfurt Prime Standard: QIA) today announced that the company has ... GmbH to develop and commercialize predictive assays in oncology. An ... a marker to predict effectiveness of anthracycline treatment in triple ... are pleased to partner with Therawis, which developed the PITX2 ...
(Date:5/25/2016)... YORK , May 25, 2016 ... Market Size, Share, Development, Growth and Demand Forecast to ... Syringe, Insulin Pump and Others)" published by P&S Market ... at $9,998.3 million in 2015, and it is expected ... Based on type, the insulin pump segment is expected ...
(Date:5/25/2016)... 2016 Digital Health Dialog, LLC dba ... the US Patent and Trademark Office of U.S. ... processes for electronic opt-­in and processing of discount ... HIPAA compliance and otherwise. Logo - ... "Our technology allows for individuals to opt­-in ...
Breaking Medicine Technology: