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Is Nitric Oxide Anesthesia Safe in Neurosurgery?


Clinical trial finds that nitrous oxide anesthesia was safe for neurosurgery patients.

A clinical trial has investigated the safety of Nitrous Oxide gas as an anesthetic used in neurosurgery procedures.

Nitrous oxide, also known as laughing gas, is a common anesthetic used in many medical procedures. Inhaled nitrous oxide (N2O) was first used for labor analgesia in the 1880s in the United Kingdom. N2O has properties that are desirable for analgesia. Its low blood solubility and minimal metabolism (<1%) allow for a rapid effect and low tissue absorption. However, there have been concerns about its safety during neurosurgery, where patients are at a higher risk of complications.

Clinical Trial

The trial has shed light on the safety of nitrous oxide as an anesthetic for neurosurgery. It analyzed data from the ENIGMA trials, which involved patients undergoing neurosurgery under nitrous oxide anesthesia.

The trial involved 830 patients undergoing neurosurgery procedures. These patients were divided into two groups; the intervention group received nitrous oxide while the control group received an alternative anesthetic agent. 417 received nitrous oxide anesthesia, and 413 received nitrous oxide-free anesthesia. Of these, 507 (95%) underwent spinal neurosurgery and 28 (5%) underwent cranial neurosurgery.


The results of the clinical trial showed that patients in the nitrous oxide group had lower inspired oxygen concentration (30% vs. 38%) and end-tidal nitrous oxide concentration (0.56 vs. 0.89 minimal alveolar concentration equivalents) compared with the nitrous oxide-free group. The use of nitrous oxide was not associated with an increased risk of postoperative complications (myocardial infarction, cardiac arrest, stroke, infection, severe vomiting, fever, pneumonia, pneumothorax, blood transfusion, venous thromboembolism, or death). The average length of hospital stay was 5 days for the nitrous oxide group compared to 4.2 days for the control group.

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These findings suggest that nitrous oxide anesthesia was safe for a selected group of patients undergoing neurosurgery. The findings of this clinical study are significant because they refute the commonly held notion that nitrous oxide may not be safe for neurosurgery procedures. On the contrary, researchers have found this anesthetic agent to be safe and effective for neurosurgery.


The clinical trial provides valuable insights into the safety of nitrous oxide anesthesia in a selected group of patients undergoing neurosurgery. While there may be some risks associated with nitrous oxide anesthesia, the trial suggests that it can be used safely in these patients. It is important for patients to discuss their anesthesia options with their healthcare providers and make informed decisions based on their individual circumstances.

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This content is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of such advice or treatment from a personal physician. All readers/viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. CenTrial Data Ltd. does not take responsibility for possible health consequences of any person or persons reading or following the information in this educational content. Treatments and clinical trials mentioned may not be appropriate or available for all trial participants. Outcomes from treatments and clinical trials may vary from person to person. Consult with your doctor as to whether a clinical trial is a suitable option for your condition. Assistance from generative AI tools may have been used in writing this article.