You are planning the anesthetic for an upcoming carotid endarterectomy. Based on the equivocal results of the General Anaesthesia versus Local Anaesthesia for Carotid Surgery (GALA) trial, you decide to perform a general anesthetic. A colleague suggests always using nitrous oxide (N2O) for quicker emergence in these cases. Reflecting on a recent secondary analysis of the GALA trial, you respond:

The question about general versus local anesthesia for carotid endarterectomy was addressed by the GALA trial. This trial looked at more than 3,000 patients and ultimately concluded that there were no differences in 30-day occurrences of stroke, MI, or death between the two techniques.

The use of N2O in general anesthesia has been addressed in studies such as the Evaluation of Nitrous Oxide in the Gas Mixture for Anaesthesia (ENIGMA) trial and a secondary analysis of the Intraoperative Hypothermia for Aneurysm Surgery Trial (IHAST). The ENIGMA...

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