BACKGROUND Endothelial function is impaired with hyperhomocysteinemia. Plasma homocysteine is increased by nitrous oxide anesthesia. The current study was designed to determine whether endothelial function is impaired after surgery and whether this is made worse by exposure to nitrous oxide. METHODS The authors studied 59 patients with cardiovascular disease undergoing noncardiac surgery. Pat...

The driving skills of 10 dental students were evaluated on three occasions on a driving simulator after exposure to air and 50% and 70% nitrous oxide in oxygen. Errors increased after exposure to nitrous oxide and were statistically significant during the middle of the test period. Driving after short exposure to nitrous oxide appears inadvisable.

Although rare, tympanic membrane rupture during general anesthesia with nitrous oxide has been reported previously in the literature. Nitrous oxide administration and the effects on closed body cavities will be reviewed. Key factors in patient assessment which can determine safe use of nitrous oxide in the clinical setting will also be discussed.

The concentrations of nitrous oxide were determined at various positions in four dental surgeries in which nitrous oxide sedation was used without scavenging. Contamination was present in all the surgeries, the greatest concentration being recorded at the dentist's nose and the least in the peripheral air. The reception area adjoining the surgeries was found also to be contaminated by nitrous o...

We describe a case of myeloneuropathy resulting from nitrous oxide abuse. MR imaging of the spine revealed symmetric abnormal signal in the posterior columns of the cervical cord. Myeloneuropathy is caused by inactivation of vitamin B12 by nitrous oxide. This syndrome can also be seen in patients with borderline vitamin B12 deficiency who have recently been anesthetized with nitrous oxide.

J Neurosci Methods 2007; 160: 215–22 17 Shafer SL, Hendrickx JF, Flood P, Sonner J, Eger EI II. Additivity versus synergy: a theoretical analysis of implications for anesthetic mechanisms. Anesth Analg 2008; 107: 507–24 18 Kuhlmann L, Foster BL, Liley DT. Modulation of functional EEG networks by the NMDA antagonist nitrous oxide. PLoS One 2013; 8: e56434 19 Barr G, Jakobsson JG, Owall A, Anders...

The objective of this study was to assess the changes in transcutaneous oxygen tension in pediatric patients undergoing nitrous oxide-oxygen analgesia. A total of 19 healthy patients, ranging in age from 3 to 19 years with a mean age of 9.8 years, were included. Transcutaneous oxygen monitoring was performed; following stabilization, baseline readings were obtained. Oxygen was delivered at 3 I/...

ADVANCES in the understanding of anesthetic pharmacology and perioperative physiology, coupled with improved patient monitoring, have significantly contributed to improvements in quality of care and perioperative outcome. In this issue of ANESTHESIOLOGY, Samarska et al. describe preclinical research that addresses the anesthetic modulatory effects on the physiologic adaptation to hemorrhagic sh...

The pattern of ventilation was studied in eight greyhounds anaesthetized with halothane in 50% oxygen with nitrogen and in eight with the same concentration of halothane in 50% oxygen with nitrous oxide. There was a significant reduction in both inspiratory and expiratory times in the animals breathing nitrous oxide and an increase in the negative pressures developed in the obstructed airway du...

BACKGROUND 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 sub...