Death from Nitrous Oxide

Abstract

Nitrous oxide is an inflammable gas that gives no smell or taste. It has a history of abuse as long as its clinical use, and deaths, although rare, have been reported. We describe two cases of accidental deaths related to voluntary inhalation of nitrous oxide, both found dead with a gas mask covering the face. In an attempt to find an explanation to why the victims did not react properly to oncoming hypoxia, we performed experiments where a test person was allowed to breath in a closed system, with or without nitrous oxide added. Vital signs and gas concentrations as well as subjective symptoms were recorded. The experiments indicated that the explanation to the fact that neither of the descendents had reacted to oncoming hypoxia and hypercapnia was due to the inhalation of nitrous oxide. This study raises the question whether nitrous oxide really should be easily, commercially available.

<p>Clinical, Electrophysiological and Radiological Features of Nitrous Oxide-Induced Neurological Disorders</p>

“…N 2 O abuse could cause subacute combined degeneration, myelopathy, demyelinating polyneuropathy, emotional disorders and even death. 6,[9][10][11] In our present study, the most common clinical manifestation was the classic presentation of peripheral neuropathy with superficial sensory deficit and distal limb paresis. The symptoms and signs of ataxia, vibration and position sense impairment and unsteady gait were also founded on a considerable number of patients, suggesting the posterior column was frequently affected.…”

“…[7][8][9][10] There have even been deaths related to N 2 O inhalation. 11 Considering about the lack of awareness of N 2 O-abusing toxicity, we conducted a clinical study, which included a comprehensive and updated review of N 2 O abuse-induced neurological disorders. In this study, we also summarized the clinical manifestations, laboratory and electrodiagnostic characteristics, and magnetic resonance findings of 33 patients having N 2 O abuse-induced neurological disorders.…”

Recurrent paraparesis and death of a patient with ‘whippet’ abuse

“…The main cause of death was amphetamine intoxication, but nitrous oxide might have been a contributing factor. There are rare cases of deaths associated with nitrous oxide abuse [ 6 , 7 ]. The mechanism of death remains to be elucidated, but the patients have shown signs of asphyxia, which has been hypothesized to be caused by the lack of brain reactivity to hypoxia and hypercapnia due to the nitrous oxide [ 6 ].…”

“…There are rare cases of deaths associated with nitrous oxide abuse [ 6 , 7 ]. The mechanism of death remains to be elucidated, but the patients have shown signs of asphyxia, which has been hypothesized to be caused by the lack of brain reactivity to hypoxia and hypercapnia due to the nitrous oxide [ 6 ]. However, part of the fatal cases that have been reported were due to insuffocation caused, e.g., by an airtight mask that was used to inhale nitrous oxide [ 6 ].…”

Further Support for the AVMA-Approved Rodent Euthanasia Protocol

“…Adolescents who use "crackers" to self-administer CO 2 "whippet" containers (for dispensing whipped cream) to get a "high" [38] and 3. The self-inhalation of Nitrous oxide (NO) party balloons at "raves" [39] provide atmospheric conditions closely approximating those occurring in the rat in the euthanasia chambers. All adolescent abuse of such inhalants has been linked to the subjective state of being "high", or "euphoric".…”