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(Medical-NewsWire.com, November 14, 2012 ) San Francisco, CA -- Researchers are reporting that nitrous oxide does not appear to increase risk in cardiovascular complication during surgery.
A randomized and controlled trial showed that there was no significant difference in the levels of cardiac marker troponin in patients that were given the ‘laughing gas’ alone. There was also no significant change for those who were given the gas with B vitamins, according to Peter Nagele, MD and colleagues during the oral session at the American Society of Anthesiologists meeting.
Nagele stated that there seemed to be no difference in myocardial infarction rates; however, he was clear that the study was not strong enough “for definitive evidence,” and that “…we’ll have for the ENIGMA-II trial.”
Nitrous oxide is commonly used as anesthetic, typically utilized in combination with other inhalation or intravenous compounds. The laughing gas itself is not a strong anesthetic, but is more often utilized to remove the need for opioids and pain relievers, which can bring with them other complications.
Researchers noted that the commonly known fact that nitrous oxide results in an acute increase in plasma homocysteine still exists. The chronic elevations of such a homocysteine are associated with cardiovascular disease. Particular subgroups appear to have greater elevations in response to nitrous oxide than other groups.
Nagele and his colleagues utilized Vitamins in Nitrous Oxide (VINO) in trials to offset the effects of oxide-induced increases in homocysteine levels, which can increase the risk of perioperative MI.
Trial included looking at whether the addition of B-vitamins, particularly B12 and folic acid, could handle the potential heart risk that is related to elevated homocysteine.
The trial utilized 500 patient sample of randomized nitrous oxide, combined with B-vitamins or placebo, with 125 receiving neither.
Researchers noted increased homocysteine in those patients with nitrous oxide alone. Those with nitrous oxide and B-vitamins had an early increase, which quickly fell away, rather than lingering like the former group.
Those in the group that received neither agent had normalized homocysteine by the postoperative day, said Nagele.
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