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Nitrous oxide in pediatric anesthesia: friend or foe?

机译:小儿麻醉中的一氧化二氮:是敌还是友?

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PURPOSE OF REVIEW: Nitrous oxide has been used in clinical practice for over 150 years, often for pediatric procedures. Not only are there problems when used in patients with a variety of inborn errors of metabolism, but effects of nitrous oxide on the developing human brain are unknown. RECENT FINDINGS: A recent adult human trial found that the use of nitrous oxide was associated with increased adverse outcome. Animal studies in several species have shown that nitrous oxide can be associated with apoptosis in the developing brain. Nitrous oxide can also inhibit major enzymatic pathways and repeated exposure may lead to neurologic damage. Single nucleotide polymorphisms in at least one of these enzymes are common in the population. SUMMARY: There is a growing body of evidence that supports avoidance of nitrous oxide in both pediatric and adult patients, but the thousands of patients who have been exposed to nitrous oxide without apparent complications would suggest that further studies on long-term side effects and possible neurologic consequences need to be done.
机译:审查目的:一氧化二氮已在临床实践中使用了150多年,通常用于儿科手术。当用于患有各种先天性代谢错误的患者时,不仅存在问题,而且一氧化二氮对发育中的人脑的作用尚不清楚。最近的发现:一项最近的成人人体试验发现,使用一氧化二氮会增加不良后果。对几种动物的动物研究表明,一氧化二氮可能与大脑发育中的细胞凋亡有关。一氧化二氮还可以抑制主要的酶促途径,反复接触可能导致神经系统损害。这些酶中至少一种的单核苷酸多态性在人群中很常见。简介:越来越多的证据支持在儿科患者和成年患者中避免使用一氧化二氮,但是成千上万的暴露于一氧化二氮而没有明显并发症的患者将建议对长期副作用进行进一步的研究,并可能神经系统后果需要做。

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