Severe combined degeneration of the spinal cord after nitrous oxide anaesthesia in a vegetarian.

Rösener, MT; Dichgans, J.

doi:10.1136/jnnp.60.3.354

Cited by 36 publications

(17 citation statements)

References 5 publications

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“…There are many examples of such case reports (Schilling, 1986;Holloway & Alberico, 1990;Flippo & Holder, 1993;Kinsella & Green, 1995;Nestor & Stark, 1996;Rosener & Dichgans, 1996;Sesso et al, 1999;Marie et al, 2000;Waters et al, 2005;Cartner et al, 2007;Wu et al, 2007;Meyers & Judge, 2008;Singer et al, 2008;Somyreddy & Kothari, 2008). Those at risk of vitamin B12 deficiency include some vegetarians (in particular vegans), the newborn of vegetarian mothers, patients with GI pathology, elderly people or patients taking PPIs and H2 blockers, and alcoholics (Schilling, 1986;Rosener & Dichgans, 1996;Nilsson-Ehle, 1998;Schenk et al, 1999;Carmel, 2000;McNeely et al, 2000;Sanders et al, 2008). In individuals who are not vitamin B12 deficient, larger quantities or more prolonged use of N 2 O seems to be required before neurotoxicity is seen.…”

Section: Toxicitymentioning

confidence: 99%

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

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Objectives: This study aimed to assess analgesia provided by acupuncture, alone or in combination with pharmacotherapy, to patients presenting to emergency departments with acute low back pain, migraine or ankle sprain. Design: A pragmatic, multicentre, randomised, assessor‐blinded, equivalence and non‐inferiority trial of analgesia, comparing acupuncture alone, acupuncture plus pharmacotherapy, and pharmacotherapy alone for alleviating pain in the emergency department. Setting, participants: Patients presenting to emergency departments in one of four tertiary hospitals in Melbourne with acute low back pain, migraine, or ankle sprain, and with a pain score on a 10‐point verbal numerical rating scale (VNRS) of at least 4. Main outcome measures: The primary outcome measure was pain at one hour (T1). Clinically relevant pain relief was defined as achieving a VNRS score below 4, and statistically relevant pain relief as a reduction in VNRS score of greater than 2 units. Results: 1964 patients were assessed between January 2010 and December 2011; 528 patients with acute low back pain (270 patients), migraine (92) or ankle sprain (166) were randomised to acupuncture alone (177 patients), acupuncture plus pharmacotherapy (178) or pharmacotherapy alone (173). Equivalence and non‐inferiority of treatment groups was found overall and for the low back pain and ankle sprain groups in both intention‐to‐treat and per protocol (PP) analyses, except in the PP equivalence testing of the ankle sprain group. 15.6% of patients had clinically relevant pain relief and 36.9% had statistically relevant pain relief at T1; there were no between‐group differences. Conclusion: The effectiveness of acupuncture in providing acute analgesia for patients with back pain and ankle sprain was comparable with that of pharmacotherapy. Acupuncture is a safe and acceptable form of analgesia, but none of the examined therapies provided optimal acute analgesia. More effective options are needed. Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12609000989246.

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Section: Toxicitymentioning

confidence: 99%

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

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show abstract

“…Such neuropathies are thus a major problem in the recreational and less frequently also after anesthesia [102]. Numbness, tingling, ataxia and/or muscle weakness, and impotence are frequently described [103,104]. Animal studies have confirmed these effects [105,106].…”

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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“…Case reports illustrate that these patients or newborns of mothers with these problems may present hematological and neurological complications after exposure to nitrous oxide 82 (D) 83,84 (C).…”

Section: Hematological and Neurological Complicationsmentioning

confidence: 99%

“…The effects of nitrous oxide on vitamin B 12 -dependent pathways in patients with deficiency of the methionine synthase enzyme are not known, but it seems reasonable to avoid its use in children with deficiency of this enzyme, as well as other B 12 vitamin metabolism defects 83,84,86,87,89 (C) 90 (A).…”

Section: Recommendationsmentioning

confidence: 99%

“…Patients with vitamin B 12 deficiency developed different hematological and neurological manifestations, after intraoperative exposure to nitrous oxide 82 (D) 83,84 (C). Thus, various authors raise the concern about the administration of nitrous oxide to children, given the high prevalence of metabolic defects and vitamin deficiencies in this population.…”

Section: Hematological and Neurological Complicationsmentioning

confidence: 99%

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