Severe Neurologic Deficit After Nitrous Oxide Anesthesia

Hadžić, Admir; Glab, Krzysztof; Sanborn, Kevin V.; Thys, Daniel M.

doi:10.1097/00132586-199610000-00046

Cited by 2 publications

(2 citation statements)

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“…Anesthesia with nitrous oxide has been reported to induce postoperative neurological deficit in rare anecdotal cases. Hadzic et al43 describe a patient who presented with paresthesia and gait instability 6 weeks after undergoing a procedure with nitrous oxide anesthesia. Other cases of subacute combined degeneration of the spinal cord several weeks after surgery due to vitamin B 12 deficiency have been reported 44.…”

Section: Discussionmentioning

confidence: 99%

Comprehensive Perioperative Approach to Complex Spine Deformity Management

Camargo

Abode-Iyamah²,

Shah³

et al. 2021

Clinical Spine Surgery: A Spine Publication

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Objective: Study perioperative strategies for optimizing neuroprotection in complex spine deformity correction surgery. Methods: We report the case of a patient with severe lumbar dextroscoliosis, thoracolumbar junction hyperkyphosis with a 40-degree Cobb angle levoconvex scoliosis who underwent spinal deformity correction with loss of neuromonitoring during surgery. We performed a literature review on perioperative management of complex spine deformity. Results: A 50-year-old man presented with lumbar pain and right L4 radiculopathy. Surgical intervention for deformity correction and decompression was indicated with T4−L4 posterior instrumentation L2/L3 and L3/L4 transforaminal lumbar interbody fusion. Surgery was aborted due to the loss of neuromonitoring. Postsurgery, the patient had left sensory deficit and the neurocritical care team clinically suspected and deduced the anatomic location of the spinal cord compression. Magnetic resonance imaging confirmed a T10−T11 hyperintensity suggestive of cord ischemia due to osteophyte compressing the spinal cord. The patient underwent a second corrective surgery with no intraoperative events and has no long-term neurological sequela. Conclusions: This case illustrates that a comprehensive perioperative approach and individualized risk factor assessment is useful in complex spine deformity surgery. Further research is needed to determine how this individualized comprehensive approach can lead to intraoperative and postoperative countermeasures that improved spine surgery outcomes. Level of Evidence: Level V.

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Section: Discussionmentioning

confidence: 99%

Comprehensive Perioperative Approach to Complex Spine Deformity Management

Camargo

Abode-Iyamah²,

Shah³

et al. 2021

Clinical Spine Surgery: A Spine Publication

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“…Prolonged exposure to N 2 O can also cause a myeloneuropathy similar to subacute combined degeneration of the cord. 31 Acute exposure may precipitate a similar clinical syndrome in patients with pre-existing subclinical vitamin B12 deficiency, 32 and depression of white cell formation may also occur. 33 Addiction to N 2 O has occasionally been reported, 34 and misuse should be considered in those presenting with suspicious neurological symptoms or signs.…”

Section: Side Effectsmentioning

confidence: 99%

Nitrous oxide in emergency medicine

O’Sullivan

Benger²

2003

Emergency Medicine Journal

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Severe Neurologic Deficit After Nitrous Oxide Anesthesia

Cited by 2 publications

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Comprehensive Perioperative Approach to Complex Spine Deformity Management

Comprehensive Perioperative Approach to Complex Spine Deformity Management

Nitrous oxide in emergency medicine

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