Treatment of post-traumatic stress disorder with medical nitrous oxide combined with exposure to a personal traumatic script: a multicenter randomized controlled trial (POTESTA)

Start Date01 Jan 2027

Sponsor / Collaborator

Centre Hospitalier Regional Universitaire De Tours

ChiCTR2600131282

/ Not yet recruitingNot ApplicableIIT

Analgesic efficacy of diluted nitrous oxide on patients with maxillofacial trauma

Start Date01 Sep 2026

Sponsor / Collaborator-

NCT07690358

/ RecruitingNot ApplicableIIT

Undersøgelse af Lattergaskoncentrationer i Blod, udåndingsluft og Urin Ved Forskellige Eksponeringer

The study examines the concentrations of nitrous oxide that are achieved in blood, exhaled air, and urine after three different exposures to nitrous oxide:
inhalation of three or four cartridges of nitrous oxide released in a car cabin in a switched-off car, consumption of 100 g of whipped cream in which nitrous oxide is used as a propellant, and exposure through work as a midwife in a delivery room.
The concentrations in blood and exhaled air are measured for up to 1 hour after exposure, and in urine for up to 2 hours after exposure. The concentrations in blood and urine are measued with gas chromatography and mass spectrometry, while the concentration in exhaled air is measured by a sensor using an NDIR sensor (Olythe, France).

Start Date01 Jun 2026

Sponsor / Collaborator

University of Aarhus

100 Clinical Results associated with Nitrous Oxide

100 Translational Medicine associated with Nitrous Oxide

100 Patents (Medical) associated with Nitrous Oxide

41,590

Literatures (Medical) associated with Nitrous Oxide

31 Dec 2026·ANNALS OF MEDICINE

Analgesic effect of premixed nitrous oxide in postoperative rehabilitation for ankle fractures: a randomized controlled trial

Article

Author: Tang, Lu ; Wang, Yuchen ; Dou, Jiayi ; Qiu, Xueling ; Sun, Chenxi ; Wang, Weifeng ; Zhang, Liting ; Cao, Wenjuan ; Wang, Fei

INTRODUCTION:

The global incidence of ankle fractures is on the rise, effective postoperative rehabilitation is a crucial aspect of surgical management. However, the occurrence of severe pain during the rehabilitation continues to pose a substantial clinical challenge.

METHODS:

The study utilizes a dual-arm, single-center, double-blind, randomized controlled trial design. A total of 100 participants were enrolled. Participants included patients experiencing acute pain (self-reported pain score ≥4) who underwent postoperative rehabilitation for ankle fractures. Participants undergoing rehabilitation training were randomized to receive either 65% nitrous oxide or 100% oxygen. The primary outcome measured was the pain score, while secondary outcomes encompassed anxiety scores, physiological indices, side effects, patient and therapist satisfaction, acceptance, and residual pain.

RESULTS:

Pain scores were found to be significantly lower in the nitrous oxide group than in the oxygen group (T1: median difference -3.0, [95% CI -3.4 to -2.6]; p < 0.001; T2: median difference -2.0, [95% CI -2.8 to -1.2]; p < 0.001). Compared with the oxygen group, both therapists (p < 0.001) and participants (p < 0.001) in the nitrous oxide group reported significantly higher satisfaction levels. Acceptance rate showed significant intergroup differences (p < 0.001). No severe adverse effects were observed in either group. Anxiety scores between the two groups did not show a significant difference (p = 0.31, η² = 0.027).

CONCLUSION:

The safety and analgesic profile of nitrous oxide renders it a suitable option for pain management in postoperative ankle fractures rehabilitation, thus providing a safe and easily manageable alternative to the current available strategies.

CLINICAL TRIAL REGISTRATION:

We have registered at https://www.chictr.org.cn and the registration number is: ChiCTR2400089379.

01 Dec 2026·Medical Gas Research

Environmental impact of anesthetic gases

Review

Author: Costa, Ana ; Tong, Jing ; Mucevic, Hana ; Bennici, Lesley

Healthcare systems are known to negatively impact the environment, with the operating room significantly contributing to these issues. Specifically, anesthetic gases have been a recent target of many sustainability initiatives, as they are known to be greenhouse gases and have traditionally been a cornerstone of providing general anesthesia. This review focuses on the current literature regarding the impact of anesthetic gases on the environment, including common definitions such as global warming potential and carbon dioxide equivalents. The most commonly used anesthetic gases are reviewed, including their impact on the atmosphere, as well as strategies to reduce their negative impact while maintaining their availability for use in the practice of anesthesiology. Specifically, the clinical applications of the commonly used anesthetic gases, namely sevoflurane, desflurane, isoflurane and nitrous oxide are discussed. This review further identifies and explores alternative methods that help mitigate the negative environmental impact of anesthetic gases, including gas capturing systems, low flow anesthesia and total intravenous anesthesia, as well as barriers to implementing these strategies. We conclude that while many strategies exist to minimize the environmental impact of anesthetic gases, implementation is often hindered by factors such as institutional buy-in and cost/return on investment ratio.

01 Dec 2026·MOLECULAR BIOLOGY REPORTS

Molecular and toxicogenetic safety profile of short-term nitrous oxide anesthesia in surgical patients

Article

Author: Chen, C-Y Oliver ; Lara, Juliana R ; Braz, José Reinaldo C ; Braz, Leandro G ; Braz, Mariana G ; Silva, Mariane A P ; Nogueira, Flávia R

Abstract:

Background:

Nitrous oxide (N2O) is a widely used anesthetic; however, its potential to compromise genomic stability by disrupting vitamin B12 and folate metabolism remains a critical concern in clinical molecular biology. Since N2O can oxidize cobalamin, it may theoretically impair the methionine synthase pathway, leading to DNA damage. Thus, this study aimed to evaluate the toxicogenetic impact—DNA damage and gene expression—and the metabolic profile of vitamins B9 and B12, homocysteine (HCY) and micronutrients/antioxidants in patients undergoing short-term N2O anesthesia.

Methods and Results:

Adult surgical patients without comorbidities ( n = 18/group) were assessed at: pre-anesthesia, during anesthesia (1.5 h exposure), and 24 h post-anesthesia. Both groups received desflurane, with one also receiving N2O. The primary focus was on DNA strand breaks (comet assay) and the transcriptional levels (RT-qPCR) of repair ( OGG1 and XRCC1 ) and antioxidant ( HO-1 ) genes, followed by HPLC and chemiluminescence analysis of metabolic markers (HCY and antioxidants, vitamins B9 and B12). N2O exposure did not modulate the mRNA expression of any of the studied genes, nor did it alter HCY, vitamin levels or antioxidants ( p > 0.05). A transient, group-independent increase in DNA damage was observed post-anesthesia, suggesting a primary response to surgical stress rather than the anesthetic agent.

Conclusions:

Our study provides high-evidence molecular data demonstrating that 1.5 h of N2O exposure is safe for genomic integrity and vitamin B-related metabolism in healthy individuals. These findings are clinically relevant as they validate the continued use of N2O in minimally invasive procedures without the risk of acute toxicogenetic or metabolic impairment.

News (Medical) associated with Nitrous Oxide

29 Jul 2026

·www.prnewswire.com

ECRI Names Cottage Health Winner of 2026 Health Technology Excellence Award

Innovative blood management initiative recognized for reducing waste through proactive interfacility transfers. FORT WASHINGTON, Pa., July 29, 2026 /PRNewswire/ -- ECRI, a nonprofit organization advancing the safety and quality of healthcare, has honored Cottage Health with its 2026 Health Technology Excellence Award. The annual award recognizes an ECRI member facility for implementing an exceptional initiative to improve patient safety, reduce costs, or otherwise advance the strategic management of health technology. Cottage Health in Santa Barbara, Calif., developed an interfacility blood transfer program that has significantly reduced the wastage of blood products that occurs when red blood cell (RBC) units reach their expiration date before they can be transfused. The organization's systematic process for safely redistributing RBC units from lower-utilization facilities to its high-utilization Level I trauma-certified hospital, where the blood is more likely to be transfused before expiration, has dramatically reduced wastage. The financial benefits of the program are calculated to exceed $100,000 annually. Harder to measure, but no less valuable, are the benefits to patient care and to the community at large. The program helps ensure that a precious, donated resource is available for patients when needed, and it demonstrates the organization's commitment to honoring the social contract with volunteer donors, who give their blood expecting it to help patients. "We are honored to receive this recognition from ECRI," said Lisa Moore, Executive Vice President and Chief Operating Officer at Cottage Health. "By reducing blood waste, this program helps ensure a lifesaving resource is available for patients when they need it while honoring the generosity of every blood donor." Designing Reliability and Safety into the System As part of the program, Cottage Health established mechanisms to identify RBC units that were within 10 days of expiration and initiate their transfer to the trauma center in time for them to be transfused as needed. Successful implementation required a robust infrastructure, the deployment of specialized technologies (e.g., validated temperature-controlled blood unit coolers to ensure product viability during transport), and coordinated workflows. Documentation steps throughout the process allow for full traceability and quality assurance. As the program matured, transfusion rates for transferred units climbed from 85.2% during the first year to consistently above 98% in subsequent years, demonstrating a system designed to learn and improve over time. "Cottage Health has demonstrated what is possible when organizations treat health technology management and resource stewardship as system-based challenges," said Scott Lucas, Vice President of Devices, Therapeutics, and Technology at ECRI. "The team created a reliable, sustainable model that improves patient care, reduces waste, and strengthens the organization's bond with the community, showing how systems-focused technology management can deliver lasting value." 2026 Runner-Up Clínica Imbanaco, part of Grupo Quirónsalud in Cali, Colombia, was selected as the Runner-Up for the 2026 Health Technology Excellence Award for its efforts to reduce the environmental impact and safety risks associated with the use of inhaled anesthetic agents. Clínica Imbanaco conducted a comprehensive, systems-based analysis to identify and implement safer and more environmentally sustainable anesthesia administration techniques. Notably, the effort helped the organization eliminate the use of nitrous oxide and desflurane—two agents with high global warming potential and occupational risk for healthcare personnel—without compromising patient safety or the quality of care. The project achieved an 89.36% reduction in halogenated anesthetic use and a 60.6% reduction in carbon footprint while advancing patient safety, worker safety, and environmental responsibility. This recognition marks the third time that Clínica Imbanaco Grupo Quirónsalud has been recognized through ECRI's Health Technology Excellence Awards program, including being named the annual winner in 2024. About Cottage Health Cottage Health is a not-for-profit health system providing advanced medical care on California's Central Coast. In the past year, its hospitals in Goleta, Santa Barbara and Santa Ynez Valley cared for 20,833 inpatient admissions, 93,281 emergency department visits and 1,971 newborn deliveries. With more than 700 physicians, including specialists typically found only at university medical centers, Cottage offers expert, comprehensive care. As a teaching institution, it trains physicians through residency programs in medical, surgical, pediatric and radiology specialties. Cottage Health is home to the Central Coast's only Level I adult and Level II pediatric trauma center and an advanced comprehensive stroke center. Its specialty services include Cottage Children's Medical Center, Cottage Rehabilitation Hospital, the Santa Barbara Neuroscience Institute, Cottage Heart & Vascular Center and Cottage Center for Orthopedics. Beyond its hospitals, Cottage expands care through primary and specialty clinics, urgent care centers and 24/7 provider access via Cottage Virtual Care. About ECRI ECRI is an independent, nonprofit organization improving the safety, quality, and cost-effectiveness of care across all healthcare settings. With a focus on technology evaluation and safety, ECRI is respected and trusted by healthcare leaders and agencies worldwide. Over the past six decades, ECRI has built its reputation on integrity and disciplined rigor, with an unwavering commitment to independence and strict conflict-of-interest rules. ECRI is the only organization worldwide to conduct independent medical device evaluations. ECRI is designated an Evidence-based Practice Center by the U.S. Agency for Healthcare Research and Quality. The ECRI and Institute for Safe Medication Practices PSO is a federally certified Patient Safety Organization (PSO) as designated by the U.S. Department of Health and Human Services. ECRI acquired The Institute for Safe Medication Practices (ISMP) in 2020 to address one of the most prolific causes of preventable harm in healthcare, medication errors; then acquired The Just Culture Company in 2024 to transform healthcare workplace cultures – thus creating one of the largest healthcare quality and safety entities in the world. Visit . SOURCE ECRI 21% more press release views with Request a Demo

Clinical ResultAcquisition

11 Dec 2025

·www.drugs.com

Nitrous Oxide May Help With Depressive Symptoms

WEDNESDAY, Dec. 10, 2025 -- Nitrous oxide (N 2 O) can offer fast-acting depressive symptom relief, according to a review published online Nov. 30 in eBioMedicine . Kiranpreet Gill, from the University of Birmingham in the United Kingdom, and colleagues conducted a systematic literature review to identify data on the efficacy and safety of N 2 O in depressive disorders. Based on seven included clinical trials (247 participants), the researchers report that N 2 O was administered via inhalation at 25 percent or 50 percent, as single or repeated sessions, with comparators including air, oxygen, or midazolam. For the three trials administering 50 percent N 2 O in a single session, there were significant reductions in depressive symptoms at two hours and 24 hours. However, the effect was not significant at one week postinhalation. There were reports of mild and transient adverse events, with 25 percent N 2 O generally better tolerated. Most trials were early-phase and focused on short-term outcomes in adults with major depressive disorder or treatment-resistant depression . "Our analyses show that N 2 O could form part of a new generation of rapid-acting treatments for depression," Gill said in a statement. "Importantly, it provides a foundation for future trials to investigate repeated and carefully managed dosing strategies that can further determine how best to use this treatment in clinical practice for patients who don’t respond to conventional interventions." Several authors disclosed financial ties to the pharmaceutical industry. Abstract/Full Text

Clinical Result

02 Dec 2025

·www.sciencedaily.com

Fast depression relief? Nitrous oxide shows remarkable potential

Nitrous oxide may offer quick, short-term relief for people with major depression, especially those who haven’t responded to standard medications. The meta-analysis found rapid improvements after a single dose and more sustained benefits after repeated treatments. Side effects were generally mild and brief, though researchers stress the need for larger, longer-term studies.Patients living with major depressive disorder, including those who have not improved with commonly prescribed antidepressants, may benefit from short-term nitrous oxide treatment, according to a large meta-analysis led by the University of Birmingham. The paper, published in eBioMedicine on November 30, reviewed the strongest available clinical data to explore how clinically administered nitrous oxide (N2O) might provide fast-acting relief from depressive symptoms in adults with major depressive disorder (MDD) and treatment-resistant depression (TRD). What treatment-resistant depression is and how common it can be TRD is defined as depression that remains insufficiently controlled after a person has tried two different antidepressant medications. A previous study led by the same research team found that around 48% of patients in the UK gain only limited benefit from standard antidepressant treatments, highlighting a substantial unmet need. Researchers from the University of Birmingham, the University of Oxford, and Birmingham and Solihull Mental Health NHS Foundation Trust evaluated seven clinical trials and four protocol papers conducted by research groups across the world. These studies examined the use of nitrous oxide, which is also widely used as a pain relief option in medical procedures, as a treatment for depressive disorders including MDD, TRD and bipolar depression. Single sessions, repeated doses and how nitrous oxide may act in the brain The analysis showed that a single session of inhaled clinical nitrous oxide at 50% concentration (in three of the trials) led to rapid and meaningful reductions in depressive symptoms within 24 hours. However, these improvements did not generally persist after one week. When patients received repeated treatments over several weeks, the benefits lasted longer, indicating that a course of multiple sessions, rather than a one-off dose, may be necessary to sustain clinical improvement. Nitrous oxide is believed to act on glutamate receptors in a manner similar to ketamine, another rapid-acting antidepressant. This action on glutamate pathways may account for the relatively swift improvements in mood that are seen shortly after inhalation. Kiranpreet Gill, a PhD researcher funded by the Medical Research Council at the University of Birmingham and first author of the study, said: "Depression is a debilitating illness, made even more so by the fact that antidepressants make no meaningful difference for almost half of all patients diagnosed with it. There is a growing body of research on repurposing treatments from other clinical domains to alleviate low mood. This study brings together the best possible evidence indicating that nitrous oxide has the potential to provide swift and clinically significant short-term improvements in patients with severe depression. "Our analyses show that nitrous oxide could form part of a new generation of rapid-acting treatments for depression. Importantly, it provides a foundation for future trials to investigate repeated and carefully managed dosing strategies that can further determine how best to use this treatment in clinical practice for patients who don't respond to conventional interventions." Strong short-term evidence, but more trials are needed The meta-analysis reported robust evidence that nitrous oxide can improve mood over the short term after administration. At the same time, the relatively small number of clinical trials meant there were noticeable differences in how depressive symptoms were measured and reported, as well as in the timing of follow-up assessments. The authors note that further research is essential to identify the most effective dosing regimen, to fully understand the long-term safety of nitrous oxide, and to work out how best to incorporate it into existing treatment pathways. Safety pro side effects of nitrous oxide The researchers also evaluated safety and side effects. Some participants experienced issues such as nausea, dizziness and headaches, but these problems were short lived and resolved without the need for medical treatment. Higher doses at 50% concentration were linked with a greater chance of these side effects occurring, yet none of the studies identified any immediate safety concerns. The team stressed that long-term safety must still be clarified through future studies that include longer follow-up periods. Professor Steven Marwaha from the University of Birmingham, Honorary Consultant Psychiatrist at Birmingham and Solihull Mental Health Foundation Trust, and senior author of the study said: "This is a significant milestone in understanding the potential of nitrous oxide as an added treatment option for patients with depression who have been failed by current treatments. This population has often lost hope of recovery, making the results of this study particularly exciting. These findings highlight the urgent need for new treatments that can complement existing care pathways, and further evidence is needed to understand how this approach can best support people living with severe depression." Expanding options for treatment-resistant depression in diverse communities The study was carried out by researchers at the Mental Health Mission Midlands Translational Centre, which is led by the University of Birmingham and funded by the National Institute for Health and Care Research through the NIHR Oxford Biomedical Research Centre. The team is focused on improving treatment options for treatment-resistant depression in superdiverse and deprived communities. The Centre's goal is to speed up the development and rollout of innovative, evidence-based treatments that can both enhance outcomes and reduce inequalities in mental health care. This work also connects with ongoing initiatives at the Birmingham Clinic for Advanced Mood Disorder Management (CALM), where advanced, evidence-based treatments such as ketamine and neuromodulation are already being provided for people living with severe or treatment-resistant depression. Next steps: preparing the first NHS trial of nitrous oxide for depression Building on this translational pathway that moves discoveries into real-world care, the team is now planning the first NHS trial in the UK to examine whether nitrous oxide can be offered safely and in an acceptable way as a treatment for major depression. The results of this upcoming trial will guide how nitrous oxide might be incorporated into NHS services and could broaden the range of innovative treatment choices available for patients who have not gained adequate relief from standard approaches.

Clinical StudyClinical Result

100 Deals associated with Nitrous Oxide

External Link

KEGG	Wiki	ATC	Drug Bank
D00102	-	N01AX13	-

R&D Status

10 top approved records.

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Indication	Country/Location	Organization	Date
Anesthesia	Japan	Koike Medical Co., Ltd.	01 Jan 1984
Pain	Japan	Koike Medical Co., Ltd.	01 Jan 1984

Clinical Result

Indication

Phase

Evaluation

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Study	Phase	Population	Analyzed Enrollment	Group	Results	Evaluation	Publication Date


NCT01891812 (CTgov)	Phase 2	Vaso-occlusive crisis \| Anemia, Sickle Cell	5	NSAIDs+hydromorphone+nitrous oxide (N2O)+morphine	iojjhewtht(wccxjgyvok) = bythpnbsjc wcsktwjaoc (iiqbikzaly, fupzkvosgl - godabsjnbl) View more	-	16 Jul 2024
NCT05803096 (CTgov)	Phase 4	Pain \| Fear \| Anxiety Disorders ... View more	143	Nitrous Oxide (Self-Administered Nitrous Oxide)	isagmoqbri(iqoakqgypb) = tvitzfojhb msvpazvcdq (iyupglteix, vjfhcuecfz - edlcsokihq) View more	-	30 Jan 2024
				Oxygen (Oxygen)	isagmoqbri(iqoakqgypb) = goggduckna msvpazvcdq (iyupglteix, mgfvsugehs - rugbhmssov) View more
NCT04378426 (N2OP, CTgov)	Phase 2	Stress Disorders, Post-Traumatic	1	Oxygen+Nitrous Oxide+Saline (Nitrous Oxide)	gexcfqvxao(ylzbqttpzi) = ocgnfbukrs lmvupkrbak (nnrdpvzyvm, 0) View more	-	03 Mar 2023
				Nitrogen+Midazolam (Midazolam)	zqacnvsxoi(akcvdkkckr) = gfazpravet azyuihconi (kibeyzgwqs, mbqgfgedrr - kqqpcztjlx) View more
NCT02410707 (CTgov)	Not Applicable	Perianal abscess \| Joint Dislocations	43	Oxygen+Propofol+Nitrous Oxide arm	igmocugthf = uvorbjpvzq uzloprlmrd (iruzocikri, hhuscskxvm - suiyswznnm) View more	-	08 Apr 2020
NCT03365011 (CTgov)	Phase 4	Tinnitus	40	Placebo gas for inhalation (Placebo)	sgnofgelbd(weijzxqoeu) = bmxqkmynxn poejongxqz (mwypaxeuok, 8.8) View more	-	06 Nov 2018
				Nitrous oxide gas for inhalation (Nitrous Oxide)	sgnofgelbd(weijzxqoeu) = sxancwkjpu poejongxqz (mwypaxeuok, 11.0) View more
ASN2018	Not Applicable	-	152	Nitrous Oxide (Laparoscopic PD catheter insertion with N2O under regional anesthesia)	czdmrlgzym(bgrbrevaph) = One patient required unexpected hospitalization due to intraoperative bleeding requiring a blood transfusion vaxhgnsrky (xiukmfgiux ) View more	Positive	23 Oct 2018
NCT03365011 (Pubmed \| JAMA Otolaryngol Head Neck Surg)	Phase 4	Tinnitus	40	Placebo	qimnmobbib(abewysgwfl) = jvhlscchii ujeyqjoqwl (waozvogopy )	Negative	01 Sep 2018
				Nitrous oxide	qimnmobbib(abewysgwfl) = lnrpnsjxea ujeyqjoqwl (waozvogopy )
UEGW2015	Not Applicable	Esophageal dysplasia	-	Nitrous oxide cryotherapy using CbFAS	tbttaduirg(xszlyvneaw) = One patient had mild odynophagia and chest pain ibrudxpiwc (vdresglcmz ) View more	-	01 Oct 2015
ASH2006	Not Applicable	-	-	Nitrous oxide	pngzkvchnh(zezsbidwji) = saiqqpqhng jvenlfpxkv (tmekezagcm ) View more	-	16 Nov 2006
				Standard conscious sedation	pngzkvchnh(zezsbidwji) = gxddjxvpas jvenlfpxkv (tmekezagcm ) View more
Pubmed \| J Clin Anesth	Not Applicable	-	60	Sevoflurane + Nitrous oxide	zlnbadhnnp(hiyymiuxua) = uicokcgwhb pgezzmvzgt (ruanfmdnla )	-	01 May 2002
				Sevoflurane	zlnbadhnnp(hiyymiuxua) = bkzgcdpcpd pgezzmvzgt (ruanfmdnla )

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