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  • Title: Studies on the haemopoietic toxicity of nitrous oxide in man.
    Author: Skacel PO, Hewlett AM, Lewis JD, Lumb M, Nunn JF, Chanarin I.
    Journal: Br J Haematol; 1983 Feb; 53(2):189-200. PubMed ID: 6821648.
    Abstract:
    Nitrous oxide inactivates vitamin B12 and in man can produce a megaloblastic anaemia. Haematological and biochemical changes were studied in nine surgical patients ventilated with 70% N2O for up to 24 h and in three control patients. There was a rise in the numbers of hypersegmented neutrophils in peripheral blood following N2O. Serial bone marrow aspirates showed gross megaloblastic change after 24 h of N2O which had reverted to normoblastic but dyserythropoietic haemopoiesis by 1 week. Giant forms of early myeloid precursors were also seen after 24 h ventilation with N2O but by 1 week abnormalities were evident in more mature cells, metamyelocytes and segmented neutrophils. Megaloblastosis was associated with abnormal dU suppression which showed a correction pattern similar to that seen in vitamin B12 deficiency. Administration of N2O was also associated with a progressive rise in serum folate and fall in serum methionine levels. No similar patterns were seen in the three control patients.
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