Nitrous oxide, commonly known as laughing gas, is a widely used inhalation anesthetic agent in the United States. In recent years, questions have been raised concerning its safety - with some studies suggesting that the nitrous oxide anesthesia may raise the risk of a heart attack during and after surgery by inactivating vitamin B12, thereby increasing blood levels of the amino acid homocysteine. High level of homocysteine is said to be associated with an increased risk for coronary artery disease.
But a new study by researchers at Washington University School of Medicine suggests that the nitrous oxide sedation fears may be unfounded.
As part of the study, lead author Peter Nagele and his colleagues followed 500 surgery patients at elevated risk of heart attack who underwent noncardiac surgery and had received nitrous oxide anesthesia.
The patients were divided into two groups, with one group receiving intravenous vitamin B12 and folic acid to help prevent homocysteine levels from rising during surgery while the other group was not given the intravenous B vitamins.
To detect heart attacks during and after surgery, the researchers monitored a marker of heart damage, cardiac troponin I, for 72 hours. If the troponin level rises, it means there is some form of damage to heart muscle.
The researchers, who monitored the influence of nitrous oxide anesthesia on B vitamins and homocysteine and studied how it affected the risk of heart attack, also looked at gene variations in the patients that naturally lead to elevated homocysteine.
Although, the B vitamins kept homocysteine levels from rising, neither the gene variation nor treatment with B vitamins had an effect on troponin levels following surgery, according to the researchers. Simply put, as per the study findings, using nitrous oxide as an anesthetic during surgery did not increase heart attack risk.
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