November 1, 2000Anesthesia & Analgesia
Nitrous Oxide-Induced Increased Homocysteine Concentrations Are Associated with Increased Postoperative Myocardial Ischemia in Patients Undergoing Carotid Endarterectomy
Key result
General anesthesia with nitrous oxide during carotid endarterectomy increased the incidence of postoperative myocardial ischemia compared to anesthesia without nitrous oxide (46% vs. 25%, P<0.05).
Why the study?
Does nitrous oxide anesthesia increase postoperative myocardial ischemia and homocysteine levels in patients undergoing carotid endarterectomy?
Population
90 ASA Class I–III patients presenting for elective carotid endarterectomy
Comparison
General anesthesia with nitrous oxide vs General anesthesia without nitrous oxide
Design
RCT, randomized
Follow-up
48 hours
Authors
Discussion
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Member takes
Implication
Avoid nitrous oxide in carotid endarterectomy anesthesia; RCT confirms increased postoperative myocardial ischemia risk.
Study Design
Type
RCT (n=90)
Randomization
randomized
Structured PICO
Does nitrous oxide anesthesia increase postoperative myocardial ischemia and homocysteine levels in patients undergoing carotid endarterectomy?
P
Population
90 ASA Class I-III patients presenting for elective carotid endarterectomy, monitored for 48 hours postoperatively.
I
Intervention
General anesthesia with nitrous oxide
C
Comparator
General anesthesia without nitrous oxide
O
Outcome
Postoperative plasma homocysteine levels and myocardial ischemia (assessed by Holter monitor) up to 48 hours postoperativelysurrogate
Main Result
Absolute Event Rate: 46% vs 25%
p-value: p=<0.05
The use of nitrous oxide during carotid endarterectomy increases postoperative plasma homocysteine concentrations and is associated with a higher incidence of postoperative myocardial ischemia.
Cite This Study
Badner et al. (2000) conducted an RCT in Patients undergoing carotid endarterectomy (n=90). Nitrous oxide vs. No nitrous oxide was evaluated on Incidence of myocardial ischemia (p=<0.05). General anesthesia with nitrous oxide during carotid endarterectomy increased the incidence of postoperative myocardial ischemia compared to anesthesia without nitrous oxide (46% vs. 25%, P<0.05).