Advertisement

Clinical Biochemistry of N2O: Recent Advances

  • J. Rupreht
Conference paper

Abstract

Contrary to the beliefs on the use of nitrous oxide (N2O) of ten years ago, the role of N2O in medicine has been established. More than ever, N2O is being used during total intravenous anaesthesia but to the anaesthesia researcher, N2O is of greater importance. N2O has proven to be a most excellent agent to study the phenomenon of acute tolerance to drugs which alter functioning of the brain [1]. There have been developments in the mechanism of the N2O-anaesthetic action [2] pointing towards a GABA-receptor related mechanism and to the fact that the reversible general anaesthetic effect may be more of an intracellular phenomenon than an extracellular one. Earlier experiments indicate that N20antinociceptive effect can be enhanced biochemically [3]. This, however, has not been followed by studies which would demonstrate if indeed, it is possible to improve N2O performance in clinical practice.

Keywords

Nitrous Oxide Folinic Acid Pernicious Anaemia Total Intravenous Anaesthesia Acute Tolerance 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Ramsay DS et al (1992) Acute tolerance to nitrous oxide in humans. Pain 51: 367–373PubMedCrossRefGoogle Scholar
  2. 2.
    Dzoljic M (1996) Nitrous oxide: a study on neurons. Thesis. Foundation for Single Cell Research, LeidenGoogle Scholar
  3. 3.
    Rupreht J et al (1984) Enkephalinase inhibition prevented tolerance to nitrous oxide analgesia in rats. Acta Anaesthesiol Scand 28: 617–620PubMedCrossRefGoogle Scholar
  4. 4.
    Fiege M et al (1998) Gefährdung von Patienten mit schwerer chronischer Neutropenie durch Lachgasexposition. Anästhesiologie & Intensiv Med 39: 347–350Google Scholar
  5. 5.
    Nunn JF, Halsey MJ (1990) Xenon in anaesthesia. Lancet 336: 112–113PubMedCrossRefGoogle Scholar
  6. 6.
    Rupreht J (1990) Nitrous oxide: full rehabilitation of its use in medicine. Giornale di Medicina Critica (Trieste) 2: 171–174Google Scholar
  7. 7.
    Shaw ADFS, Morgan M (1998) Nitrous oxide: time to stop laughing? Editorial. Anaesthesia 53: 213–215PubMedCrossRefGoogle Scholar
  8. 8.
    Halsey MJ (1995) Occupational exposure to inhalational anaesthetics. Anaesthesia Rounds. Zeneca Pharmaceuticals ( Education ), AbingdonGoogle Scholar
  9. 9.
    Ermens AAM et al (1994) Monitoring cobalamin during nitrous oxide anesthesia by determination of homocysteine in plasma and urine. Clin Pharmacol Therap 49: 385–393CrossRefGoogle Scholar
  10. 10.
    Kano Y et al (1984) Effect of leucovorin and methylcobalamin with nitrous oxide anesthesia. J Lab Clin Med 104: 711–717PubMedGoogle Scholar
  11. 11.
    Amos RJ et al (1982) Incidence and pathogenesis of acute megaloblastic bone marrow change in patients receiving intensive care. Lancet 2: 835–839PubMedCrossRefGoogle Scholar
  12. 12.
    Nunn JF (1987) Clinical aspects of interaction between nitrous oxide and vitamin B12. Br J Anaesth 59: 3–13PubMedCrossRefGoogle Scholar
  13. 13.
    Rupreht J (1989) Lachgas kan vrij van biochemische bijwerkingen. Ned Tijdschr Anesth 4: 14–16Google Scholar
  14. 14.
    Christensen B et al (1994) Preoperative methionine loading enhances restoration of the cobalamin-dependent enzyme methionine synthase after nitrous oxide anaesthesia. Anesthesiology 80: 1046–1056PubMedCrossRefGoogle Scholar
  15. 15.
    Landon MJ et al (1992) Influence of vitamin B12 status on the inactivation of methionine synthase by nitrous oxide. Br J Anaesth 69: 81–86PubMedCrossRefGoogle Scholar
  16. 16.
    Kroes ACM (1987) The inactivation of cobalamin by nitrous oxide. Application in experimental chemotherapy of leukemia. Thesis, Erasmus University Rotterdam, The NetherlandsGoogle Scholar

Copyright information

© Springer-Verlag Italia 2000

Authors and Affiliations

  • J. Rupreht

There are no affiliations available

Personalised recommendations