Nitrous Oxide Poisoning

Abstract

Nitrous oxide poisoning is commonly seen in cases where it is intentionally abused, typically inhaled to induce euphoria and pleasure. It is popularly known as "laughing gas." Additionally, nitrous oxide is used in various industries, such as in airbags in vehicles, as a propellant in whipped cream production, in non-stick cooking sprays, in foaming agents, and as a gas for packaging. Nitrous oxide is a colorless, non-flammable gas that acts quickly and wears off rapidly. Inhaling it in large quantities can lead to asphyxia, causing headaches, cardiac arrhythmia, hypotension, seizures, and unconsciousness, potentially leading to death. Long-term misuse of nitrous oxide can affect the oxidation process of vitamin B12, resulting in symptoms similar to vitamin B12 deficiency, such as myeloneuropathy (disease of the spinal cord and nerves), numbness, paresthesia, ataxia, and weakness. The diagnosis of nitrous oxide poisoning is based on the symptoms and history exposure. The general treatment is to remove the patient from the source of exposure to ventilated area with closely supportive care. For patients experiencing wheezing, beta-2 agonists may be considered. In cases of prolonged abuse, vitamin B12 supplementation can reduce the severity of myeloneuropathy.