Megaloblastic Bone Marrow Changes After Repeated Nitrous Oxide Anaesthesia

Nunn, J.F.; Chanarin, I.; Tanner, A G; Owen, E. R. T. C.

doi:10.1093/bja/58.12.1469

Cited by 40 publications

(18 citation statements)

References 4 publications

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“…In a study of 18 intensive therapy unit patients with nitrous oxide administration followed by megaloblastic bone marrow changes there was an 89% mortality rate [2,7]. While short term exposure to nitrous oxide does not affect bone marrow function, nitrous oxide exposure longer than 12 hours does produce temporary bone marrow abnormalities, including megaloblastic hematopoiesis.…”

Section: Discussionmentioning

confidence: 99%

“…These nutrients have a critical role in the synthesis of DNA. Nitrous oxide inhibits the enzyme methionine synthase, a critical enzyme in nucleic acid synthesis, by inhibiting cobalamin from acting as a coenzyme [1,2]. As a result patients develop disordered blood cell proliferation, which subsequently can cause pancytopenia and altered immune function.…”

Section: Introductionmentioning

confidence: 99%

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Megaloblastic hematopoiesis in a 20 year old pregnant female

et al. 2013

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SummaryBackground:Nitrous oxide can cause disordered blood cell proliferation and lead to pancytopenia and altered immune function.Case Report:A young pregnant female patient presented after binge nitrous oxide abuse with altered mental status and abnormal vital signs. From her initial assessment she was noted to have pancytopenia and was found to have megaloblastic, hyper-cellular changes in a subsequent bone marrow biopsy. This presentation was determined to be secondary to toxic effects after heavy use of nitrous oxide.Conclusions:Nitrous oxide exposure, including use as an inhalant, over 12 hours can lead to bone marrow abnormalities such as megaloblastic hematopoiesis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Megaloblastic hematopoiesis in a 20 year old pregnant female

et al. 2013

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“…Inzwischen wird Lachgas beschuldigt, durch seine Einwirkungen auf den Vitamin B 12-Metabolismus myelodepressorisch und teratogen zu wirken [62]. Außerdem werden Lachgas ausgeprägte emetische Nebenwirkungen zugeschrieben.…”

Section: Nebenwirkungen Volatiler Anästhetikaunclassified

Propofol zur Narkose und Kurzzeitsedierung

Reinhold

Kraus²,

Schlüter

1998

Der Anaesthesist

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Since its introduction in clinical use more than ten years ago, propofol is well appreciated for sedation and supplemental hypnosis in anaesthesia. However the substance is approved only for anaesthesia in children elder than three years. As can be substantiated by many data reported in literature, there are no pharmacokinetic or pharmacodynamic reasons whatsoever to withhold propofol from the younger children; this applies both to the use as a narcotic supplement and as a short term hypnotic for diagnostic and therapeutic interventions.

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“…3 Although N 2 O is teratogenic in rats at high doses, 4 evidence of reproductive effects in humans is equivocal. Early studies on spontaneous abortion in operating theatre staff [5][6][7] as well as dated and recent surveys of dental assistants 8,9 or midwives 10 do not permit accurate risk estimation.…”

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confidence: 99%

Environmental monitoring of nitrous oxide during dental anaesthesia

Henderson¹,

Matthews²

2000

Br Dent J

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AimThe study was carried out to see if levels of nitrous oxide in dental theatres and community dental clinics were being controlled in accordance with the Control of Substances Hazardous to Health Regulations. Setting A multi-centre study looked at exposure levels in a dental teaching hospital and two community dental clinics in the South Wales area between 1997 and 1998. Methods A MIRAN infra-red spectrophotometer was used to measure static levels of nitrous oxide during general anaesthesia and conscious sedation. NIOSH method 6600 was used to collect personal samples of the individual administering the anaesthetic. Results The results showed compliance with the regulations when averaged out over an 8 hour time weighted average. However, over short periods of time peak concentrations of up to 1190 ppm were observed through static sampling, and up to 734 ppm through personal sampling. Conclusions The results highlighted the need to provide adequate control measures such as anaesthetic gas scavenging, to reduce occupational exposure to dental staff in dental operating theatres and community dental clinics, therefore providing a safe working environment.

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Megaloblastic Bone Marrow Changes After Repeated Nitrous Oxide Anaesthesia

Cited by 40 publications

References 4 publications

Megaloblastic hematopoiesis in a 20 year old pregnant female

Megaloblastic hematopoiesis in a 20 year old pregnant female

Propofol zur Narkose und Kurzzeitsedierung

Environmental monitoring of nitrous oxide during dental anaesthesia

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