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

A multi-centre non-inferiority cluster trial comparing outcomes related to nitrous oxide delivery by portable cylinder and pipeline in all patients undergoing surgery under general anaesthesia: Nitrous Oxide management to Balance heaLthcare and Environmental needs (NOBLE)

Status
Recruiting
Phases
Unknown
Study type
Interventional
Source
ISRCTN
Registry ID
ISRCTN66370377
Enrollment
14400
Registered
2025-02-27
Start date
2025-04-01
Completion date
Unknown
Last updated
2026-03-23

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

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

Interventions

The NOBLE trial will have two distinct phases each lasting 5 weeks. Hospitals will be randomised 1:1 either to a control phase (pipeline nitrous oxide supply) followed by an intervention phase (cylind

Sponsors

University of Birmingham
Lead Sponsor

Eligibility

Sex/Gender
All

Inclusion criteria

Inclusion criteria: All patients (adults and children) undergoing surgery under general anaesthesia in participating hospitals (regardless of exposure to nitrous oxide anaesthesia)

Exclusion criteria

Exclusion criteria: Patients who have opted out of anonymous data sharing Patients undergoing repeat surgery within 30 days after a procedure recorded in the NOBLE trial

Design outcomes

Primary

MeasureTime frame
Days Alive and At Home Within 30 Days after surgery (DAH30). The day of surgery is defined as day zero. Patients who die within 30 days after surgery will be given a value of zero. DAH30 data will be collected from routine data in patient health records by local investigators who are members of the direct care team.

Secondary

MeasureTime frame
1. Use of nitrous oxide anaesthesia during surgery (Y/N) 2. Mortality within 30 days after surgery 3. Major complications during surgery (Clavien-Dindo grade =III) 4. Duration of hospital stay (days) 5. NHS costs of nitrous oxide provision All secondary outcome measures will be collected from routine hospital records at 30 days after surgery

Countries

England, Scotland, United Kingdom, Wales

Contacts

Public ContactRachel Lillywhite
noble@trials.bham.ac.uk+44 (0)7514800721

Outcome results

None listed

Source: ISRCTN (via WHO ICTRP) · Data processed: Apr 3, 2026