Asphyxial Deaths from the Recreational Use of Nitrous Oxide

Abstract

The recreational use of nitrous oxide is widespread. Nitrous oxide for recreational use is usually obtained from anesthesia tanks or whipped-cream machine chargers or cans. Twenty previously described deaths associated with recreational nitrous-oxide use describe anesthesia tanks and whipped-cream machine dispensors as a source. Five deaths associated with nitrous oxide use are presented; two involving whipped-cream cannisters as the source, two involving anesthesia tanks, and one involving a racing fuel tank as a source of nitrous oxide. Autopsy findings in our cases were subtle or negative, but usually suggestive of asphyxia. Through a laboratory simulation, we have confirmed that nitrous oxide displaces oxygen in a closed space, which probably leads to asphyxia. A review of the literature, neuropharmacology, and pathophysiology of nitrous oxide use is also presented.

Autoerotic accident associated with self-applied ketamine

“…The minority included the use of nitrous oxide (laughing gas) [15,25,26,27], electrocution [28,29], anaesthetics [30], propane inhalation [31], nitrites [32], gasoline sniffing [33], tetrachlorethylene intoxication [34] and thoracic compression [35,36]. This article describes an exceptional autoerotic accident involving the use of a complicated mechanical restraint and the self-administered injection of ketamine by an intravenous catheter.…”

Temporal trends over the past two decades in asphyxial deaths in South Australia involving plastic bags or wrapping

“…Death from oxygen deprivation associated with this type of inert gas exposure is a well-reported event in both suicides and accidents [16][17][18][19] and has been recommended for use in assisted suicides. Although identification of gases such as helium in tissues and fluids may not be possible 20,21 , head-space analysis should always be undertaken if other gas or volatile inhalation is suspected.…”

The adverse effects of nitrous oxide

“…Deaths can occur with this method of administration. 20 The practice is called 'nanging', 'a term apparently invented by users to represent the repetitive sound distortions they hear when using N 2 O'. 18 The popularity of nanging may in part be related to N 2 O's apparent ability to enhance sexual fantasies.…”