Nitrous Oxide and Serious Morbidity and Mortality in the POISE Trial

被引：26

作者：

Leslie, Kate ^{[1
,2
]}

Myles, Paul ^{[3
,4
]}

Devereaux, Philip J. ^{[5
,6
]}

Forbes, Andrew ^{[7
]}

Rao-Melancini, Purnima ^{[8
]}

Williamson, Elizabeth ^{[7
,9
]}

Xu, Shouchun ^{[10
]}

Foex, Pierre ^{[11
]}

Pogue, Janice ^{[8
]}

Arrieta, Maribel ^{[12
,13
]}

Bryson, Gregory L. ^{[14
]}

Paul, James ^{[15
]}

Paech, Michael J. ^{[16
,17
]}

Merchant, Richard N. ^{[18
]}

Choi, Peter T. ^{[19
]}

Badner, Neal ^{[20
]}

Peyton, Philip ^{[21
,22
]}

Sear, John W. ^{[23
]}

Yang, Homer ^{[24
]}

机构：

[1] Royal Melbourne Hosp, Dept Anaesthesia & Pain Management, Melbourne, Vic, Australia

[2] Univ Melbourne, Dept Pharmacol, Melbourne, Vic, Australia

[3] Alfred Hosp, Dept Anaesthesia & Perioperat Med, Melbourne, Vic, Australia

[4] Monash Univ, Acad Board Anaesthesia & Perioperat Med, Melbourne, Vic 3004, Australia

[5] McMaster Univ, Dept Med, Hamilton, ON, Canada

[6] McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada

[7] Monash Univ, Dept Epidemiol & Prevent Med, Melbourne, Vic 3004, Australia

[8] McMaster Univ, Populat Hlth Res Inst, Hamilton, ON, Canada

[9] Univ Melbourne, Sch Populat Hlth, Melbourne, Vic, Australia

[10] CAMS, Fu Wai Cardiovasc Hosp, Beijing, Peoples R China

[11] Univ Oxford, Nuffield Div Anaesthet, Oxford, England

[12] Nueva Granada Mil Univ, Bogota, Colombia

[13] Cent Mil Hosp, Dept Anaesthesia Resuscitat & Pain Management, Bogota, Colombia

[14] Ottawa Hosp, Dept Anesthesiol, Ottawa, ON, Canada

[15] McMaster Univ, Dept Anesthesia, Hamilton Hlth Sci, Hamilton, ON, Canada

[16] Univ Western Australia, Sch Med & Pharmacol, Perth, WA 6009, Australia

[17] King Edward Mem Hosp Women, Dept Anaesthesia & Pain Med, Perth, WA, Australia

[18] Royal Columbian Hosp, Dept Anesthesia & Perioperat Med, New Westminster, BC, Canada

[19] Univ British Columbia, Dept Anesthesiol, Vancouver, BC V5Z 1M9, Canada

[20] Univ Western Ontario, Dept Anesthesia, London, ON, Canada

[21] Austin Hosp, Dept Anaesthesia, Melbourne, Vic 3084, Australia

[22] Austin Hosp, Dept Surg, Melbourne, Vic 3084, Australia

[23] Univ Oxford, Nuffield Dept Anaesthet, Oxford, England

[24] Univ Ottawa, Dept Anesthesia, Ottawa, ON, Canada

来源：

ANESTHESIA AND ANALGESIA | 2013年 / 116卷 / 05期

基金：

英国医学研究理事会; 加拿大健康研究院;

关键词：

RANDOMIZED CONTROLLED-TRIAL; ANESTHETIC PRACTICE; PROPENSITY SCORE; MAJOR SURGERY; HOMOCYSTEINE; METOPROLOL; RATIONALE; DESIGN;

D O I：

10.1213/ANE.0b013e318270014a

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

BACKGROUND: In this post hoc subanalysis of the Perioperative Ischemic Evaluation (POISE) trial, we sought to determine whether nitrous oxide was associated with the primary composite outcome of cardiovascular death; nonfatal myocardial infarction (MI), and nonfatal cardiac arrest within 30 days of randomization. METHODS: The POISE trial of perioperative beta-blockade was undertaken in 8351 patients. Nitrous oxide anesthesia was defined as the coadministration of nitrous oxide in patients receiving general anesthesia, with or without additional neuraxial blockade or peripheral nerve blockade. Logistic regression, with inverse probability weighting using estimated propensity scores, was used to determine the association of nitrous oxide with the primary outcome, MI, stroke, death, and clinically significant hypotension. RESULTS: Nitrous oxide was administered to 1489 (29%) of the 5133 patients included in this analysis. Nitrous oxide had no significant effect on the risk of the primary outcome (112 [7.5%] vs 248 [6.9%]; odds ratio [OR], 1.08; 95% confidence interval [CI], 0.82-1.44; 99% Cl, 0.75- 1.57; P = 0.58), MI (89 [6.0] vs 204 [5.6]; OR, 0.99; 95% Cl, 0.75-1.31; 99% CI, 0.69-1.42; P = 0.94), stroke (6 [0.4%] vs 28 [0.8%]; OR, 0.85; 95% CI, 0.26-2.82; 99% CI, 0.17-4.11; P = 0.79), death (40 [2.7%] vs 100 [2.8%]; OR, 1.04; 95% CI, 0.6-1.81; 99% Cl, 0.51-2.15; P = 0.88) or clinically significant hypotension (219 [14.7%] vs 544 [15.0%]; OR, 0.92; 95% CI, 0.74-1.15; 99% CI, 0.70-1.23; P = 0.48). CONCLUSIONS: In this post hoc subanalysis, nitrous oxide was not associated with an increased risk of adverse outcomes in the POISE trial patients. This analysis was limited by the observational nature of the data and the lack of information on the concentration and duration of nitrous oxide administration. Further randomized controlled trial evidence is required. (Anesth Analg 2013;116:1034-40)

引用

页码：1034 / 1040

页数：7

共 17 条

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