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Anaesthesia


Title:Pre-operative vitamin B infusion and prevention of nitrous oxide-induced homocysteine increase
Author(s):Rao, L. K. Francis, A. M. Wilcox, U. Miller, J. P. Nagele, P.
Address:Department of Anesthesiology, Washington University, St Louis, MO, USA.
Year:2010 Jul
Journal Title:Anaesthesia
Page Number:710-5
Language:eng
Volume:65
Issue:7
ISSN/ISBN:1365-2044 (Electronic). 0003-2409 (Linking)
Abstract:SUMMARY: Nitrous oxide inactivates vitamin B(12) with detrimental consequences for folate and methionine metabolism, detectable by an increase in total plasma homocysteine. We hypothesised that a pre-operative vitamin B(12) and folate infusion prevents nitrous oxide-induced homocysteine increase. Sixty-three healthy patients having elective surgery were randomly allocated to receive either B-vitamin plus nitrous oxide; placebo plus nitrous oxide or placebo plus air. Fifty-nine patients completed the study. After intravenous B-vitamin infusion, plasma vitamin B(12) and folate concentrations increased 35-fold and 12-fold, respectively, on the first postoperative measurement. Patients who received B-vitamins developed a similar increase (18%) in homocysteine after nitrous oxide (1.9 micromolxl(-1); 95% CI 0.2-3.6 micromolxl(-1)) as those who did not (22%; 2.7 micromolxl(-1); 95% CI 0.6-4.8 micromolxl(-1)). Patients not receiving nitrous oxide had no homocysteine change (0.5 micromolxl(-1); 95% CI -0.8-1.9 micromolxl(-1)), indicating that pre-operative intravenous B-vitamins may not prevent nitrous oxide-induced hyperhomocysteinaemia.

 
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