Nitrous Oxide During Surgery Could Cause Heart Attacks

A newly-published study suggests that there are risks for <"">heart attack from Nitrous Oxide when undergoing surgery and receiving general anesthesia.

The Nitrous Oxide side effects were found to be long term, said Becker’s ASC Review. The study was released by the Royal Melbourne Hospital in Australia and appears in the February issue of Anesthesia and Analgesia, the official journal of the International Anesthesia Research Society (IARS).

A prior ENGIMA trial involving 2,050 patients who underwent noncardiac surgery were randomly assigned to receive anesthesia with or without nitrous oxide, said Becker’s ASC. The study revealed an “unexpectedly high number” of heart attacks in those patients who received nitrous oxide: 30 versus 10 who did not receive nitrous oxide, noted Becker’s ASC.

The team from Royal Melbourne Hospital followed up on that trial, reviewing the long-term outcome information on affected patients and, at the median follow-up, which occurred at 3.5 years, 19 percent had died and 4.5 percent suffered a myocardial infarction, explained Becker’s ASC. An increased risk of death existed in the nitrous oxide group; nine patients, versus three in the group who had not received the drug. Stroke risk measured at about two percent in both groups, said Sify News.

Looking at the long-term Nitrous Oxide side effects, said Sify News, Dr. Kate Leslie of Royal Melbourne Hospital and colleagues found a consistently increased rate of Nitrous Oxide heart attacks that was almost 60 percent greater than those who did not receive nitrous oxide, after making adjustments for other risk factors said Sify News.

While a clear reason was not discovered for the apparent link, the team believes that it is possible that increased levels of homocysteine, an amino acid which has been linked to increased heart attack risks, could be a factor, said Sify News.

As a matter-of-fact, data from the ENIGMA study indicated that 46 percent of those patients suffering a myocardial infarction tested with increased homocysteine levels versus the 11 percent who did not experience a heart attack, wrote Sify News. Other issues could be possible, noted the team, and no prior study revealed the nitrous oxide-long-term cardiac risk, noted Sify News.

“The exact relationship between nitrous oxide administration and serious long-term adverse outcomes requires investigation in an appropriately designed large randomized controlled trial,” Dr. Leslie and co-authors concluded, quoted Sify News.

EMax Health pointed out that nitrous oxide is a popular surgical anesthesia that is also used in dental offices. The cardiac effects appear to be long-term, persisting for years, eMax Health said.

Most of the patients involved in the study were at low risk for myocardial infarction, said eMax Health, which is of concern to the researchers and presents issues regarding the safety of the relatively ubiquitous form of anesthesia.

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