Navigation Links
Using nitrous oxide for anesthesia doesn't increase -- and may decrease -- complications and death

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
Wolters Kluwer Health

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:
(Date:12/1/2015)... ... 01, 2015 , ... TCS Healthcare Technologies (TCS), a leading ... arenas, is pleased to announce that VIP Care Services, a Caprock Health Group ... ACUITY Complete Care™ Management to back their collaborative catastrophic case management initiatives. ACUITY ...
(Date:12/1/2015)... (PRWEB) , ... December 01, 2015 , ... With ... footage, and with full control over customization, the possibilities are truly endless, all with ... position randomization, overlay depth position, vertical flip, horizontal flip, depth of field and more, ...
(Date:12/1/2015)... ... December 01, 2015 , ... Tympani Inc., announced today ... status from Cisco. This designation recognizes Tympani as having fulfilled the training requirements ... targeted to the high-end enterprise contact center marketplace. , Ed Kapelinski, President of ...
(Date:11/30/2015)... (PRWEB) , ... December 01, 2015 , ... The Turks ... Journal, one of the leading digital news sites highlighting Caribbean destinations, has published five ... While much of North America shivers under chilly grey skies or worse, it's ...
(Date:11/30/2015)... Los Angeles, California (PRWEB) , ... November 30, ... ... in all the programs of the19th Bi-National Convention of the Federation of Philippine ... Resort and Casino in Las Vegas, Nevada. , 1Heart Caregiver Services, as ...
Breaking Medicine News(10 mins):
(Date:11/30/2015)... November 30, 2015 global cell culture market ... bn to US$11.3 bn by 2022 at a CAGR of 7.1% ... to grow from its 2013 value of US$6.1 bn to US$11.3 ... Transparency Market Research has announced the release of a new ... the report, titled ,Cell Culture Market - Global Industry Analysis, Size, ...
(Date:11/30/2015)... Nov. 30, 2015 Nautilus Medical Inc. today ... Management platform ( ). The release of MatrixRay ... RSNA 2015 (Radiology Society North America) in ... the U.S. --> --> ... enables access to radiology studies worldwide via a peer-to-peer ...
(Date:11/30/2015)... BANNOCKBURN, Ill. , Nov. 30, 2015 ... ), a global biopharmaceutical leader dedicated to ... diseases and underserved medical conditions, today announced ... [Antihemophilic Factor (Recombinant), PEGylated], an extended circulating ... hemophilia A based on full-length ADVATE [Antihemophilic ...
Breaking Medicine Technology: