RecruitingInterventional

Can we reduce the environmental impact of nitrous oxide anaesthesia without affecting patient care?

This study, called NOBLE, is looking into how nitrous oxide gas is used during operations under general anaesthetic. Nitrous oxide, sometimes known as 'laughing gas', is used to help people stay asleep during surgery. The way it's usually given creates some waste and might affect the environment. Hospitals are starting to use nitrous oxide from portable cylinders instead of the older system with pipes. The study wants to find out if using these cylinders is just as safe for patients and if it creates less waste. All patients having surgery under general anaesthetic at hospitals taking part will be included. This research aims to improve how we use medicines in hospitals, making them better for both patients and the planet. This study does not involve new medicines; it is about how existing ones are delivered.

At a glance

Status

Recruiting

Sponsor

University of Birmingham

Enrolment target

14,400

Start

01 Apr 2025

Estimated completion

31 Dec 2026

Method of nitrous oxide delivery in patients requiring surgery under general anaesthetic.

What is this study about?

When you have an operation, doctors often use a gas called nitrous oxide to help you stay asleep as part of your general anaesthetic. Think of it like a very controlled sleeping gas. Currently, in many hospitals, this gas comes through a system of pipes, a bit like water coming through taps in your home. However, there's a new way being introduced where the nitrous oxide comes from smaller, portable cylinders, similar to a gas canister you might use for a BBQ, but specially designed for hospitals.

This study, called NOBLE, wants to understand if using these portable cylinders is just as good and as safe for patients as the older piped system. It’s also looking at whether the cylinder method creates less waste, which is better for the environment. The main goal is to make sure patient care remains excellent, while also finding ways to be more environmentally friendly in hospitals. Your doctors will still choose the best anaesthetic for you, and this study is about how one part of that anaesthetic is delivered.

This study is important because it helps hospitals make informed choices about how they deliver medicines. By finding out if portable cylinders are as effective and safe, and potentially better for the environment, it can help shape how routine care is provided in operating theatres across the country in the future. It’s about continuing to provide top-quality care in the most responsible way possible.

Key takeaways

The study looks at two ways of delivering nitrous oxide during surgery.
It aims to see if cylinders are as safe and better for the environment than pipes.
Your medical care will not change if you're included.
Participation means your anonymous hospital records will be reviewed.
Using cylinders for nitrous oxide is already a safe and common practice.
The study helps improve hospital practices for patient care and the environment.

Who may be eligible?

The NOBLE study includes all patients, both adults and children, who are having surgery where they will be put to sleep with a general anaesthetic at hospitals that are taking part in the study. You don't specifically need to be receiving nitrous oxide to be included, as the study is about the delivery method within the hospital overall. So, if you're having an operation under general anaesthetic, you're likely to be included.

There are a few reasons why someone might not be included. If you’ve previously told the hospital that you don’t want your anonymous healthcare information to be used for research, then you won't be part of this study. Also, if you have a second operation within 30 days of one that was included in the study, that second operation won't be counted again within the study.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

Am I having an operation under general anaesthetic?
Is my hospital taking part in the NOBLE study?
Have I previously opted out of my anonymous data being used for research?
Is this my first operation under general anaesthetic within the last 30 days?

Answer every question to see your result.

What does participation involve?

If you are having surgery under general anaesthetic at a participating hospital, you will automatically be included in this study. You won't have any extra appointments, tests, or changes to your usual care because of the study. You also won't receive different medication from what your doctors would normally prescribe. The study is simply looking at how the nitrous oxide gas is delivered in the operating theatre – either from a cylinder or through pipes – rather than changing what you receive or how you are cared for.

Researchers will collect information by looking at your hospital records after your operation. This means you won't be asked to fill out any forms or provide any extra data yourself. Your doctors and nurses will continue to focus on your care. The study doesn't ask you to do anything specific; it just observes existing practice. There is no specific duration for your individual participation as it's a review of your routine care during one operation.

Potential risks and benefits

There will be no direct personal benefits for you if you are part of this study. Your medical care will be exactly the same as it would be if the study wasn't happening. Taking part in the trial doesn't involve any extra specific risks because the use of nitrous oxide from cylinders is already a common and safe practice in UK hospitals. The study's purpose is to confirm that there's no difference in safety between the cylinder and piped methods for patients. You have the right to opt out of your anonymous data being used for research at any time, and this will not affect your medical care in any way.

Locations (14)

Barts Health NHS Trust
City only
London, England
Royal Free London NHS Foundation Trust
City only
London, England
University Hospitals Plymouth NHS Trust
City only
Plymouth, England
Mid and South Essex NHS Foundation Trust
City only
Basildon, England
County Durham and Darlington NHS Foundation Trust
City only
Darlington, England
Barnet Hospital
Approximate
Barnet, England
Royal Cornwall Hospitals NHS Trust
City only
Truro, England
South Tees Hospitals NHS Foundation Trust
City only
Middlesbrough, England
Wye Valley NHS Trust
City only
Hereford, England
London North West University Healthcare NHS Trust
City only
Harrow, England
South Tyneside and Sunderland NHS Foundation Trust
Unverified
Sunderland, England
University Hospitals of Derby and Burton NHS Foundation Trust
Unverified
Derby, England

Common questions

What is nitrous oxide?

It's a gas often used as part of a general anaesthetic to help you stay asleep during surgery.

Will my surgery be different if I'm in this study?

No, your surgery and anaesthetic will be exactly the same as usual. The study only looks at how the gas is delivered.

Do I have to do anything extra if I'm included?

No, you don't need to do anything. Your participation involves researchers reviewing anonymous hospital records after your procedure.

Is using gas from cylinders safe?

Yes, using nitrous oxide from cylinders is already a common and safe way to give the gas in hospitals across the UK.

Can I choose not to be part of the study?

Yes, you can opt out of your anonymous health information being used for research at any time. Just let your hospital know.

How to find out more

Rachel Lillywhite

noble@trials.bham.ac.uk +44 (0)7514800721 Official trial record

Always speak to your GP or specialist before deciding to take part in a study.