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Patients receiving nitrous oxide as part of general anaesthesia for surgery may be at increased long-term risk of myocardial infarction (MI), say Melbourne researchers. Leslie and colleagues analysed data from the ENIGMA trial of 2 050 patients undergoing non-cardiac surgery, who were randomly assigned to receive anaesthesia with or without nitrous oxide. They found that odds of MI were nearly 60% higher in those receiving nitrous oxide. However, there was no significant increase in the risk of death or of stroke. The significance of the link between nitrous oxide and MI is unclear, and the findings need to be confirmed by larger studies, the authors say.