 |
 Due to the ability of nitrous oxide to produce a disconnected, dream-like high, it is a commonly abused substance. Outside of the medical and dental professions, it is typically administered in 100% concentrations. This practice as been going on since N2O was invented in 1793. Common street names for nitrous are "laughing gas" and "whippets." Believe it or not, cans of whip cream are a source for the gas due to their use of N2O as a propellant. When allowed to settle, the gas separates from the cream allowing only the gas to escape when the lever is pressed.5
Nitrous oxide given in 100% doses can be dangerous for several reasons. In the short term, when pure N2O is inhaled, the brain is oxygen starved for a very short time. During this time, the individual may experience a brief black out period. During this black out period, the individual loses psychomotor function resulting in physical injuries due to accidents (most often falling and hitting their head). Often this will lead to serious head trauma and broken bones and teeth. Other dangers from acute nitrous use include nausea and diffusion hypoxia.3 Diffusion hypoxia occurs when the nitrous is discontinued at the end of the procedure and produces a "hangover" type effect in the patient. Rapid diffusion of nitrous oxide from the blood back into the alveoli of the lungs results in a displacement of oxygen from the lungs and a subsequent drop in pO2. However, some literature indicates that this leads to a drop of around 2% in oxygen saturation and is only an issue in patients with an airway obstruction or cardiopulmonary disease.1, 2 Any problems can be avoided by allowing the patient to breath 100% O2 for 3-5 minutes after discontinuation of nitrous oxide.
Prolonged use can lead to severe systemic problems. Bone marrow suppression is the most severe of these problems. Inactivation of methionine synthase (a vitamin B12 dependant enzyme) by long term N2O use causes interference in the production of leukocytes and red blood cells. This can lead to anemia as well as a decrease immune response. Other dangers include hepatic and renal disease, peripheral neuropathy and decreased fertility in females. These conditions are similar to those seen in Vitamin B12 deficient individuals.3
Continue on to
|
|
