Nitrous oxide myelopathy posing as spinal cord injury

Ghobrial, George M.; Dalyai, Richard; Flanders, Adam E.

doi:10.3171/2012.2.spine11532

Cited by 12 publications

(9 citation statements)

References 29 publications

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“…Of the 16 case reports, most (n = 12) were included due to their clear description of events and symptoms upon presentation [ 35 , 38 , 40 , 41 , 42 , 49 , 50 , 51 , 58 , 59 ]. All reports gave a clear description of the post-intervention condition in terms of symptoms or lack of symptoms.…”

Section: Case Report Resultsmentioning

confidence: 99%

A Systematic Review of Recreational Nitrous Oxide Use: Implications for Policy, Service Delivery and Individuals

Allan

Cameron

Bruno

2022

IJERPH

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Background: Nitrous oxide (N2O) is a dissociative anaesthetic that is sometimes used recreationally. The prevalence of N2O use is difficult to quantify but appears to be increasing. Research on N2O harms and application of harm reduction strategies are limited. The aim of this mixed method systematic review was to collate and synthesise the disparate body of research on recreational nitrous oxide use to inform harm reduction approaches tailored for young people. Methods: To identify publications reporting the recreational use of N2O, a search of public health, psychology and social science databases was conducted. Databases included PubMed, CIHNAL, PsycINFO, Scopus and Web of Science. Grey literature and Google advanced search were also used. Due to limited published literature on the recreational use of N2O, no limit was placed on publication date or study type. A thematic synthesis extracted descriptive and analytical themes from the selected studies. Quality appraisal was conducted using the CASP Tool for Qualitative studies and the Joanna Briggs Institute case report assessment tool. Results: The search retrieved 407 reports. Thirty-four were included in the final analysis, including sixteen case reports. The included studies were primarily concerned with raising awareness of the apparently increasing use and subsequently increasing harms of recreational N2O use. There was limited reference to policy or legislative responses in any published studies, no suggestions for harm reduction strategies or application of service level responses. In general, individuals lack awareness of N2O-related harms. Conclusion: The review found three key areas that deserve further consideration including: (1) policy, (2) service delivery, and (3) harm associated with N2O use. We recommend a top–down (policy) and bottom–up (services delivery/services users) approach to harm reduction for N2O use which also includes further consultation and research with both groups. Future research could explore young people’s experience of N2O use including benefits and problems to inform contextually relevant harm reduction strategies.

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Section: Case Report Resultsmentioning

confidence: 99%

A Systematic Review of Recreational Nitrous Oxide Use: Implications for Policy, Service Delivery and Individuals

Allan

Cameron

Bruno

2022

IJERPH

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“…Of the 16 case reports, most (n=12) were included due to their clear description of events and symptoms upon presentation (Assaf, Michael, & Langford, 2020;Butzkueven & King, 2000;Chen et al, 2018;Choi, Kim, Park, Lim, & Lee, 2019;den Uil, Vermeulen, Metz, Rijbroek, & de Vries, 2018;Ehirim et al, 2017;Ghobrial, Dalyai, Flanders, & Harrop, 2012;Johnson, Mikhail, Kim, Bosco, & Huynh, 2018;Kim, Lee, & Bang, 2019;Lundin, Cherian, Andrew, & Tikaria, 2019;Pratt, Patterson, & Quin, 2020). All reports gave a clear description of the post-intervention condition in terms of symptoms or lack of symptoms.…”

Section: Case Report Resultsmentioning

confidence: 99%

“…The most common reason (n=11) for receiving a no rating in a JBI item was not clearly describing the patient's history, including the patients' medical, family, and psychosocial history (Assaf et al, 2020;Choi et al, 2019;den Uil et al, 2018;Edigin et al, 2019;Ghobrial et al, 2012;Kim et al, 2019;Mo Kin Kwok et al, 2019;Seed & Jogia, 2020;Wong et al, 2014). Moreover, some reports (n=6) failed to describe the patient characteristics in depth (Assaf et al, 2020;Bajaj et al, 2018;den Uil et al, 2018;Edigin et al, 2019;Ghobrial et al, 2012;Wong et al, 2014).…”

Section: Case Report Resultsmentioning

confidence: 99%

“…In some cases, serious degeneration and limb paralysis is observed before N₂O problems are identified (Choi et al, 2019) suggesting scope for earlier identification and intervention. Common presentations indicating problematic N₂O use include muscle weakness, stumbling and spinal cord problems (Chen et al, 2018;Ghobrial et al, 2012). One person was in a wheelchair for a year before the problem of N₂O use was diagnosed (Choi et al, 2019).…”

Section: Individualsmentioning

confidence: 99%

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A Systematic Review of Recreational Nitrous Oxide Use: Implications for Policy, Service Delivery and Individuals

Allan¹,

Cameron²,

Bruno³

2022

Preprint

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Background Nitrous Oxide (N₂O) is a dissociative anaesthetic that is sometimes used recreationally. The prevalence of N₂O use is difficult to quantify but appears to be increasing. Research on N₂O harms and application of harm reduction strategies are limited. The aim of this mixed method systematic review was to collate and synthesise the disparate body of research on recreational nitrous oxide use to inform harm reduction approaches tailored for young people. Methods To identify publications reporting recreational use of N₂O, a search of public health, psychology and social science databases was conducted. Databases included PubMed, CIHNAL, PsycINFO, Scopus and Web of Science. Gray literature and Google advanced search were also used. Due to limited published literature on the recreational use of N₂O, no limit was placed on publication date or study type. A thematic synthesis extracted descriptive and analytical themes from the selected studies. Quality appraisal was conducted using the CASP Tool for Qualitative studies and the Joanna Briggs Institute case report assessment tool Results The search retrieved 407 reports. Thirty-four were included in the final analysis including sixteen case reports. The included studies were primarily concerned with raising awareness of the apparently increasing use and subsequently increasing harms of recreational N₂O use. There was limited reference to policy or legislative responses in any published studies, no suggestions for harm reduction strategies or application of service level responses. In general, individuals lack awareness of N2O related harms. Conclusion The review found three key areas that deserve further consideration including: 1) policy, 2) service delivery, and 3) harm associated with N₂O use. We recommend a top-down (policy) and bottom-up (services delivery/services users) approach to harm reduction for N₂O use which also includes further consultation and research with both groups. Future research could explore young people’s experience of N₂O use including benefits and problems to inform contextually relevant harm reduction strategies.

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“…Also in recreational use of N 2 O does myelopathy occur [122,123,124,125,126]. Most of these patients were found to have underlying vitamin B12 deficiency that was unknown at the time of the N 2 O use.…”

Section: Neurologic Disturbancesmentioning

confidence: 99%

Nitrous oxide. Should it still be used in pediatric medicine ? (Part 1)

Booij¹

2017

Medical news of the North Caucasus

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Nitrous oxide myelopathy posing as spinal cord injury

Cited by 12 publications

References 29 publications

A Systematic Review of Recreational Nitrous Oxide Use: Implications for Policy, Service Delivery and Individuals

A Systematic Review of Recreational Nitrous Oxide Use: Implications for Policy, Service Delivery and Individuals

A Systematic Review of Recreational Nitrous Oxide Use: Implications for Policy, Service Delivery and Individuals

Nitrous oxide. Should it still be used in pediatric medicine ? (Part 1)

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