Abstract
AbstractNitrous oxide (N2O) is a gas used in medicine for its anesthetic and analgesic properties, and in industry as an oxidizing gas or propellant. This gas is also available on self-service for food use. In recent years, its use has been increasingly diverted to recreational purposes. Between 2020 and 2021, the number of serious cases of intoxication increased by 320% in France, demonstrating a major public health concern. It is also a problem for road safety, with an increase in the number of road accidents linked to the consumption of this gas. Nitrous oxide causes both short-term effects (euphoria, disorientation, etc.) and long-term effects (sensory and motor neurological disorders and thrombosis). This gas acts on the central nervous system, inducing anxiolytic, anesthetic, antidepressant and analgesic effects. Nitrous oxide is difficult to quantify because of its rapid elimination. Biological investigation is thus based on secondary anomalies linked to vitamin B12 inactivation: increased methylmalonic acid and homocysteine levels. However, these two biological markers are not specific to nitrous oxide intoxication. To improve patient support, we need to find new biological markers that are more specific to nitrous oxide intoxication.
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