12 Dec 2014

Does anaesthesia with nitrous oxide affect mortality or cardiovascular morbidity?

CCS researchers have written a study which looks at anaesthesia with nitrous oxide and its affect  on patient mortality or cardiovascular morbidity.

According to the publication, nitrous oxide has been used as a general anaesthetic for more than 160 years. Despite this, opinions about the role of nitrous oxide in modern-day practice continue to differ. One concern is that exposure to nitrous oxide may increase the risk of cardiovascular complications. Nitrous oxide oxidizes the cobalt atom in vitamin B12, inactivating methionine synthase, causing a decrease in folate metabolism and an increase in homocysteine. 

Homocysteinaemia after exposure to nitrous oxide has been well demonstrated in vivo and long-term homocysteinaemia is known to be associated with an increased risk of ischaemic heart disease. It remains unclear, however, whether this information about this surrogate outcome translates into real clinical risk.

The researchers found that they currently do not have robust evidence for how nitrous oxide used as part of general anaesthesia affects mortality and cardiovascular complications. More research is therefore required. 

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