By Jeffrey Kopman
There’s nothing funny about heart attacks, but patients being prepped for surgery can now have a good, albeit slightly inappropriate, laugh at them anyway. Contrary to previous concerns, nitrous oxide -- also known as laughing gas -- does not increase a patient’s risk of heart attack, according to a study from Washington University in St. Louis published in the journal Anesthesiology.
Researchers studied 500 surgery patients who had been diagnosed with heart attack risk factors -- such as coronary artery disease and heart failure. Patients were only considered if they were not undergoing heart surgery. All patients were given laughing gas.
Some of the patients were given intravenous vitamin B12 and folic acid to reduce their heart attack risk after surgery. The other patients were not given any vitamins.
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Previous research suggested that laughing gas caused homocysteine levels to rise, which could lead to heart attacks. However, while vitamin B12 kept homocysteine levels in check, there was no effect on heart attack risk, according to the study.
“There were no differences between the groups with regard to heart attack risk,” said lead author Peter Nagele, MD, assistant professor of anesthesiology and genetics, in a press release. “The B vitamins kept homocysteine levels from rising, but that didn’t influence heart attack risk.”
The study authors believe that practitioners should have no reservations towards using laughing gas – due to fear of perioperative cardiac events -- if they believe it can help their patients.
The Heart Health Risks of Surgery
Even if nitrous oxide and other anesthesia do not increase your risk of heart attack, surgery still carries some risk. You should always weigh the risks and benefits with your doctor before deciding on a serious surgical procedure.
Laughing gas may not be linked to heart attacks anymore, but recent research did show that general anesthesia can increase dementia risk, memory and cognitive problems.
While the University of Washington study did not focus on heart surgery patients, there are risks associated with heart surgery, including bleeding, infection, irregular heartbeats, stroke and even death. These complications are generally higher in emergency situations or if the patient has other health conditions, such as diabetes, according to the National Institutes of Health.
“Surgery increases blood pressure, so being active and maintaining good heart health is necessary to undergo surgery,” said Brian Kahn, MD, cardiologist at The Heart Center at Overlea at Mercy Medical Center in Baltimore, Md. “Because anesthesia puts stress on the body it can increase the risk of heart attack. Fitness can help with blockages and limit the effects of anesthesia.”
Deciding on Heart Surgery
Many patients, and doctors, might struggle with the decision to undergo surgery. Making the right choice can be very personal, but new methods are constantly being developed to help make the correct option clearer.
In April, a new method from the Stanford University School of Medicine used “big data” to determine which treatment option was best for heart disease patients. Researchers believe they can come up with the best treatment plan for patients by comparing the outcomes and characteristics of previous patients and historical information from their database.
Big data is just one of the tools available to help doctors and patients weigh the risks and rewards associated with heart surgery. For many patients, surgery might be the answer.
“[Surgery risks] depend on if the patient had prior risk factors," Dr. Kahn said. "There’s little risk for healthy, young 20-year olds, but there is risk for a 70-year old patient with high blood pressure. [These patients] need some sort of stress test, but if the test is normal they can be cleared for surgery. You need to decide if the heart needs to be treated before surgery.”
Surgery Patients Can Laugh Off Nitrous Oxide Heart Attack Risk, Study Says originally appeared on Everyday Health.
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