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Is nitrous oxide safe for bone marrow harvest?
G Lederhaas1, J G Brock-Utne, R S Negrin
1Department of Anesthesiology, Stanford University School of Medicine, California.
Anesthesia and Analgesia
|April 1, 1995
Summary
Nitrous oxide does not affect bone marrow viability or neutrophil engraftment in patients undergoing autologous bone marrow harvest. This study found no significant differences between groups receiving nitrous oxide and those who did not.
Area of Science:
- Anesthesiology
- Hematology
- Oncology
Background:
- Autologous bone marrow harvest is a critical procedure for patients with non-Hodgkin's lymphoma.
- General anesthesia is administered, with varying anesthetic agents potentially impacting cellular viability.
- The use of nitrous oxide during anesthesia is a common practice, but its effect on bone marrow quality is not fully understood.
Purpose of the Study:
- To prospectively evaluate the impact of nitrous oxide on bone marrow mononuclear cell viability.
- To assess the effect of nitrous oxide on neutrophil engraftment rates following autologous bone marrow transplantation.
- To compare myeloid progenitor cell function (CFU-GM) in patients receiving general anesthesia with or without nitrous oxide.
Main Methods:
- Prospective, randomized study of 38 patients undergoing autologous bone marrow harvest.
- Patients received general anesthesia with thiopental, fentanyl, vecuronium, oxygen, and isoflurane.
- Group I (n=19) received 70% nitrous oxide; Group II (n=19) did not.
- Bone marrow samples were collected pre- and post-harvest.
- Cell viability assessed via colony-forming unit-granulocyte macrophage (CFU-GM) assay.
- Neutrophil engraftment rates were monitored post-transplantation.
Main Results:
- No statistically significant differences were observed between the nitrous oxide and non-nitrous oxide groups in age, weight, or anesthetic duration.
- CFU-GM counts at both initial and final sample draws were comparable between groups.
- The time to successful neutrophil engraftment was similar for both patient groups.
- Bone marrow viability, as indicated by CFU-GM growth and engraftment, was not adversely affected by nitrous oxide exposure.
Conclusions:
- General anesthesia with nitrous oxide does not appear to compromise bone marrow viability or impair myeloid progenitor cell function.
- The use of nitrous oxide during autologous bone marrow harvest does not negatively impact neutrophil engraftment post-transplantation.
- Findings suggest that nitrous oxide can be safely used in patients undergoing autologous bone marrow procedures without compromising transplant outcomes.