| In a Nutshell
First, there are the dangers, which accompany
the inhalation of any compressed gas (making sure you get enough
air, making sure you don't freeze your lips or inflate your
head, making sure you are sitting down and won't hurt yourself
if you get dizzy). Second, there are the health effects specific to nitrous
oxide. There have been reports of immunological and reproductive
disturbances in professionals who are chronically exposed
to nitrous oxide. The immunological disturbances are documented
by Peric et al (1991) _Anesthesia_ 46: 531-7. Apparently anesthetic
personnel had been complaining about weakness and recurrent
infections and decreased peripheral blood leukocyte counts
has been found. The operating rooms were found to be improperly
ventilated, causing nitrous oxide and halothane (another anaesthetic)
to remain in the air. Even after a 3-4 week holiday,
some personnel has decreased B lymphocytes and increased red
cell count, hemoglobin concentration and haematocrit and other
disturbances. I don't have a reference handy for the reproductive
disturbances, but the study basically found that women who
were chronically exposed to nitrous had difficulty becoming
pregnant. It should be noted that these health effects are
the result of CHRONIC exposure; a single balloon at a Dead
show (or a single visit to the dentist) is unlikely to be
a problem for a healthy individual.
Aside from its psychopharmacological actions, nitrous oxide
has one other (known) significant metabolic action: it interacts
with vitamin B12. This was first reported in an in vitro study
in 1968, but didn't really receive notice from anesthesiologists
until ten years later (because Medline didn't exist yet :-)
). In 1978, however, Amess et al showed that 24 h of nitrous
oxide administration caused interference with DNA synthesis
in humans. Since then, the interaction between nitrous oxide
and B12 has been better characterized.
Basically, B12 is a bound coenzyme of methionine synthase
and has a tetrapyrrole rings with a monovalent cobalt at the
center. The cobalt functions as a methyl carrier in a transmethylation
reaction. Nitrous oxide converts the cobalt from the monovalent
form to the bivalent form. As a result, methionine synthase
activity is inhibited. Recovery is believed to require absorption
of new unoxidized B12 (and synthesis of new apoenzyme).
Humans seem to be far more resistant to complications from
this than rodents. I don't have the energy to go through the
various published studies at this point, so I will quote from
Nunn's "Clinical Aspects of the Interaction Between Nitrous
Oxide and Vitamin B12" (1987), _Br. J. Anaesth._ 59:
3-13.
It seems likely that in man, in contrast to the rat, exposure
of less than 30 minutes will not cause any measurable change
in
methionine synthase activity. In combination with a wealth
of clinical experience, this suggests that there is no special
hazard for short exposures to nitrous oxide. There is a variable
response to exposures lasting between 30 minutes and 2 h.
However, it now seems likely that exposures of more than 2
h are likely to cause intereference with hepatic methionine
synthase
activity. The paucity of human data makes it more difficult
to say how long an exposure is required to cause significant
intereference with DNA synthesis. It is likely that there
will be considerable individual variation and results obtained
in healthy patients cannot be extrapolated to the patient
who is seriously ill. Nevertheless, it seems likely that,
once methionine synthase activity is inhibited, it will remain
so for days.
With respect to repeated exposures to nitrous, be aware that
this effect can build up (Nunn gives "intervals of less
than 3 days" as a cut-off). So, go easy on the "hippie
crack," people!
Mandatory nitrous horror story: Layzer (in (1978) "Myeloneuropathy
after prolonged exposure to nitrous oxide," _Lancet_
2:1227) reports a case of 15 people who had been inhaling
nitrous oxide for long periods of time and developed a condition
resembling subacture combined degneration of the cord, whatever
that means.
I would suggest that the following types of people in particular
avoid exposure to signficant amounts of nitrous:
Pregnant women: since nitrous oxide is a known teratogen
in rodents, acting by depleting folates and partially reversible
by oral
folinic acid, we can expect a similar syndrome in humans.Vegans
who don't take B12 supplements: although documented cases
of
vegans with B12 decifiencies are scarce, theories on nutrition
indicate that vegans are unlikely to get as much B12 as other
groups of people.
Individiduals with healing wounds, infections, or immunological
disorders: I'm throwing this recommendation in based on a
"better
safe than sorry" policy. Short-term exposure to nitrous
oxide is unlikely to be a problem, but why not play it safe?
And BTW I did find a reference on sexual ideation during
nitrous oxide, which is a topic that came up some time ago.
More on that when I actually get the article.
The reason why nitrous oxide is used as a propellant is that
it dissolves in the liquid cream. When the cream escapes from
the can, the gas expands and in doing so whips the cream into
a foam. (This explanation is from the book "Food Science".)
Now, the interesting part is that nitrous oxide is an inhalation
anesthetic because it dissolves in synaptic lipid membranes.
So it's not a coincidence that nitrous oxide is a whipped
cream propellant and an inhalation anesthetic: nitrous oxide
dissolves in fatty cream and it also dissolves in fatty cell
membranes.
Lots of things work as inhalation anesthetics; the better
they dissolve in the lipid membranes, the lower the pressure
required. This is why spot removers like ether and chloroform
work as anesthetics in low concentration. At high enough pressure,
even nitrogen will dissolve in membranes; this causes nitrogen
narcosis in divers. Even an inert gas like argon will work
as an anesthetic since it will dissolve in membranes under
enough pressure.
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