Nitrous Oxide Inactivates Methionine Synthetase in Human Liver

Koblin, Donald D.; Waskell, Lucy; Watson, J. E.; Stokstad, E. L. R.; Eger, Edmond I.

doi:10.1213/00000539-198202000-00001

Cited by 76 publications

(29 citation statements)

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“…Side effects include an increased risk of nausea and vomiting (157,158). Other reported adverse effects of nitrous oxide anesthesia include impairment of cerebral blood flow-activity coupling (159), and inactivation of methionine synthase (160,161).…”

Section: Nitrous Oxide Anesthesiamentioning

confidence: 99%

Effect of Nitrous Oxide Exposure During Surgery on the Homocysteine Concentrations of Children

Pichardo¹,

Luginbuehl²,

Shakur³

et al. 2013

Survey of Anesthesiology

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In this study we determined the effect of nitrous oxide (N 2 O) on homocysteine concentrations in children and whether blood levels of folate, vitamin B12, B6, methylmalonic acid (MMA) and methylenetetrahydrofolate reductase C6777T genotype affected this relationship. Homocysteine was measured before and after N 2 O. Vitamin levels, MMA and genotype were determined preoperatively. Median age of the 32 participants was 11 months (3-126 months). All children had folate and B6 levels above deficiency values (7.4, 20nmol/L respectively). Five children had MMA levels indicating deficiency (≥0.21µmol/L). Postexposure homocysteine concentrations increased by 25% (P= <0.001). Duration of exposure and initial homocysteine concentrations were predictors of the increase (r 2 = 0.821, P= <0.001).Vitamin B12 and initial homocysteine concentrations were inversely associated (r 2 = 0.277, P= 0.004). Folate, vitamin B6 and genotype showed no effect. In conclusion, N 2 O exposure leads to increased homocysteine in children. Studies investigating benefit of pre-surgical vitamin B12 supplementation may prove worthwhile.iii ACKNOWLEDGMENTS

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Section: Nitrous Oxide Anesthesiamentioning

confidence: 99%

Effect of Nitrous Oxide Exposure During Surgery on the Homocysteine Concentrations of Children

Pichardo¹,

Luginbuehl²,

Shakur³

et al. 2013

Survey of Anesthesiology

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“…Nitrous oxide oxidizes vitamin B12 and thus decreases DNA production by the inactivation of methionine synthetase. 16 The effects of this are dosedependent megaloblastic changes seen in the bone marrow which have been demonstrated in patients exposed to 50% nitrous oxide for periods as short as five hours during cardiac bypass surgery. 3 Similar bone marrow changes have been reported in dentists who experienced chronic occupational exposure to nitrous oxide in sub-anaesthetic concentrations of 1800 ppm.…”

Section: Discussionmentioning

confidence: 99%

Exposure of operating room personnel to nitrous oxide during paediatric anaesthesia

et al. 1992

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From the Department of Anaesthesia, Alberta Children's Hospital at the University of Calgary, Calgary, Alberta.This paper was presented in part at the Canadian Anaesthetists' Society Annual Meeting in Ottawa, June 1989.Address correspondence to: Dr. C. Wood, Department of Anaesthesia, Alberta Children's Hospital, 1820 Richmond Road SW., Calgary, Alberta.Accepted for publication 15th May, 1992. Contamination of the operating theatre with trace concentrations of waste anaesthetic gases is an inevitable consequence of the use of inhalational anaesthetic agents. The health risk to operating theatre personnel resulting from chronic exposure to trace concentrations of these agents has been the subject of numerous studies during the last 20 yr. Among the agents studied, the toxic effects of nitrous oxide have been the focus of much attention. Horace Wells first demonstrated the anaesthetic properties of nitrous oxide in 1844, but it was not until 1956 that the first adverse side effects from its use were reported. In that year, Lassen described bone marrow surpression in patients sedated with nitrous oxide for long-term ventilation) Since then, possible adverse effects on bone marrow, psychomotor function, and reproductive function have been described. 2-8 This has led to concerns regarding possible ill effects from the chronic occupational exposure CAN J ANAESTH 1992 / 39:7 / pp 682-6

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“…This result was not appreciated in the medical community where it was only recognized in 1978 [63]. In 1982 was it demonstrated in patients' liver biopsies after exposure to 50-70 % N 2 O for 1.25-2.75 hours, that there was a decrease in methionine synthase [64].…”

Section: Inactivation Of Vitamin B12mentioning

confidence: 99%

“…Clinical symptoms include sensory neuropathy, myelopathy, and encephalopathy; they can occur within days or weeks after exposure to N 2 O anesthesia in people with subclinical vitamin B12 deficiency. In humans, the mean half-time for hepatic methionine synthase inactivation by 1 atmosphere N 2 O is approximately 1 hour (or 0.5 atmospheres for 2 hours), with less than 20 % residual activity after 2 atmosphere-hours of exposure [78]. However, others found 50 % reduction after exposure for 40 minutes to 50 % N 2 O [79].…”

Section: Inactivation Of Vitamin B12mentioning

confidence: 99%

Nitrous oxide. Should it still be used in pediatric medicine ? (Part 1)

Booij¹

2017

Medical news of the North Caucasus

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Nitrous Oxide Inactivates Methionine Synthetase in Human Liver

Cited by 76 publications

References 0 publications

Effect of Nitrous Oxide Exposure During Surgery on the Homocysteine Concentrations of Children

Effect of Nitrous Oxide Exposure During Surgery on the Homocysteine Concentrations of Children

Exposure of operating room personnel to nitrous oxide during paediatric anaesthesia

Nitrous oxide. Should it still be used in pediatric medicine ? (Part 1)

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