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March 28, 1986

Is Nitrous Oxide a Dangerous Anesthetic for Vitamin B12-Deficient Subjects?

Author Affiliations

From the Department of Medicine, University of Wisconsin, Madison.

JAMA. 1986;255(12):1605-1606. doi:10.1001/jama.1986.03370120083027

Two women developed significant neurologic dysfunction, consistent with subacute combined degeneration of the spinal cord, within eight weeks of being anesthetized with nitrous oxide. Investigation revealed that each had preclinical or masked vitamin B12 deficiency. The first patient had two previous ileal resections for Crohn's disease and the other had pernicious anemia. It is postulated that nitrous oxide anesthesia may precipitate neurologic disease in people with unrecognized deficiency of vitamin B12.

(JAMA 1986;255:1605-1606)