Nitrous oxide (N2O) angel or devil?

Annequin, D.

doi:10.1111/pan.13834

Cited by 4 publications

(2 citation statements)

References 13 publications

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“…We planned to do this cohort study on these young children for two reasons. On one hand, N 2 O is a wildly used inhalation anesthetic while its use remains controversial for its potential side effects related to vitamin B 12 oxidation [ 12 ]. With impaired tetrahydrofolate and methionine synthesis, deoxyribonucleic acid (DNA) synthesis and cell cycle arrest could happen [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

A retrospective cohort study on red blood cell morphology changes in pre-school age children under nitrous oxide anesthesia

Wang

Lan

et al. 2021

BMC Anesthesiol

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Background Megaloblastic anemia or bone marrow changes could occur after prolonged nitrous oxide inhalation via vitamin B12 inactivation related DNA synthesis impairment. Previous researches have studied hematological changes with nitrous oxide exposure, but only in adults or adolescents. Pre-school age children with active hematopoietic red bone marrow are more vulnerable to potential side effects of nitrous oxide and might experience growth impairment. The purpose of our study was to analyze red blood cell morphology changes under nitrous oxide anesthesia in pre-school age children. Methods One hundred thirty-six children under 5 years old scheduled for hemivertebra resection were analyzed. According to fresh gas type in anesthesia records, 71 children who received nitrous oxide in oxygen during anesthesia maintenance were categorized into the nitrous oxide group and the other 65 who received air in oxygen were the air group. Complete blood counts in perioperative period were assessed for anemia, macrocytosis, microcytosis, anisocytosis, hyperchromatosis and hypochromatosis. The peak value and change percentage were calculated for mean corpuscular volume and red cell distribution width. Results Forty-two children in the air group (64.6%) and 30 in the nitrous oxide group (42.3%) developed anemia (P = 0.009). None developed macrocytosis in both groups. Postoperative mean corpuscular volume peaked (mean [95% confidence interval]) at 83.7(82.9–84.4) fL, and 83.2(82.4–83.9) fL and postoperative red cell distribution width at 13.8% (13.4–14.2%), and 13.9% (13.6–14.2%) for the air group and the nitrous oxide group. Both the relative change of mean corpuscular volume (P = 0.810) and red cell distribution width (P = 0.456) were similar between the two groups. Conclusions No megaloblastic red blood cell changes were observed with nitrous oxide exposure for 4 h in pre-school age children undergoing hemivertebra resection.

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Section: Discussionmentioning

confidence: 99%

A retrospective cohort study on red blood cell morphology changes in pre-school age children under nitrous oxide anesthesia

Wang

Lan

et al. 2021

BMC Anesthesiol

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“…3 When prescribed as a mixture with 50% oxygen, it can be safely administered by trained professionals (eg, nurses, midwives, dentists, paramedics) during painful or distressing procedures. 4 As an inhaled intoxicant without oxygen, N 2 O (colloquially sweet-air, nos, noz, nox, hippie-crack 5 ) elicits short-lived feelings of euphoria with pleasurable psychedelic and empathogenic effects. 6 Recreational N 2 O intoxication is popular.…”

Section: Introductionmentioning

confidence: 99%

Use of the Rehabilitation Treatment Specification System (RTSS) in the management of nitrous oxide (N₂O)-induced spinal cord injury

et al. 2023

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Nitrous oxide (N2O) is an inhaled anaesthetic gas and a popular intoxicant. Excessive recreational use can cause spinal cord myelopathy. Previous studies have discussed the medical management. However, none have specified the sensorimotor rehabilitation management. This case report documents the investigations, physical rehabilitation and functional outcomes in two cases of N2O-associated myelopathy. Both presented with lower limb strength and sensorimotor integration impairments resulting in ataxic ambulation. Dorsal column signal abnormality was observed on T2-weighted MRI in one case. Myelopathy was diagnosed based on clinical presentation and both were treated with vitamin B12. Rehabilitation was conceived and specified using the Rehabilitation Treatment Specification System (RTSS). Both cases achieved independent indoor gait on hospital discharge, and full function at 9 months in one case. Appropriate and timely medical management and reasoned rehabilitation provided excellent functional outcomes for N2O-related myelopathy. By using the RTSS, reasoned rehabilitation efficacy can be tested in the future.

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MEOPA (mélange équimolaire oxygène protoxyde d’azote), un médicament antalgique de référence chez l’enfant

Annequin

2024

Journal de Pédiatrie et de Puériculture

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Nitrous oxide (N2O) angel or devil?

Cited by 4 publications

References 13 publications

A retrospective cohort study on red blood cell morphology changes in pre-school age children under nitrous oxide anesthesia

A retrospective cohort study on red blood cell morphology changes in pre-school age children under nitrous oxide anesthesia

Use of the Rehabilitation Treatment Specification System (RTSS) in the management of nitrous oxide (N₂O)-induced spinal cord injury

MEOPA (mélange équimolaire oxygène protoxyde d’azote), un médicament antalgique de référence chez l’enfant

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Nitrous oxide (N2O) angel or devil?

Cited by 4 publications

References 13 publications

A retrospective cohort study on red blood cell morphology changes in pre-school age children under nitrous oxide anesthesia

A retrospective cohort study on red blood cell morphology changes in pre-school age children under nitrous oxide anesthesia

Use of the Rehabilitation Treatment Specification System (RTSS) in the management of nitrous oxide (N2O)-induced spinal cord injury

MEOPA (mélange équimolaire oxygène protoxyde d’azote), un médicament antalgique de référence chez l’enfant

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Use of the Rehabilitation Treatment Specification System (RTSS) in the management of nitrous oxide (N₂O)-induced spinal cord injury