ENIGMA (N2O Trial)

This article was published in:

 Anesthesiology. 107(2):221-231, August 2007.

Click on the link below to view the complete article.

Avoidance of Nitrous Oxide for Patients Undergoing Major Surgery: A Randomized Controlled Trial

Summary:

This trial compares the use of  nitrous oxide-free (80% oxygen, 20% nitrogen) or nitrous oxide-based (70% N₂O, 30% oxygen) anesthesia in over 2000 patients having major surgery. The primary endpoint examined was the duration of hospital stay. Secondary endpoints included postoperative complications such as severe nausea and vomiting, pulmonary complications, wound infection and thrombotic complications, as well as many others. The authors of the trial conclude that “the routine use of nitrous oxide in patients undergoing major surgery should be questioned”.

ENIGMA- II trial is now underway. This is a multicentre trial investigating the effect of removing nitrous oxide (N2O) from the anaesthetic gas mixture in patients with coronary artery disease undergoing major surgery. It is comparing general anaesthesia and FiO₂ 0.30 with and without N₂O.

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