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I remember there being a discussion about nitrous oxide for anesthesia

and regression in the past--but I didn't pay attention because my son

had had it in the past and had not had a problem with it....We're

seeing major behavior issues/regression since his scope--and he was

given nitrous oxide and I am trying to figure out if there is a

connection and where I can find more information. Would love any

input.

Thanks-

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this is very long and a cross-post, but it should explain everything

In chelatingkids2 , Sym Rankin <symc@m...> wrote:

> I have been reading a lot of post about anesthesia problems. I am

a

> nurse anesthetist. Hopefully I can explain a few things to

everyone.

>

> Our children are deficient in B12. When we start the B12 shots,

most

> of us see great improvement in our children. Do a Google search

on

> B12 and nitrous oxide. Inhaling nitrous can deplete B12. It

seems to

> start to cause problems after 30 minutes of exposure and with

multiple

> exposures.

>

> Where I practice, this is how we take care of children. Usually

for a

> pre-op we give them Versad in some grape juice. (Versad is a

> valium-type drug that relaxes you and makes you forget.) Then

the

> children are brought to the operating room and a mask is placed on

> their face. High flow of nitrous, O2 and Sevoflourane (

Halothane is

> not used anymore) are used to get the child asleep and then an IV

is

> started. Nitrous is usually given for the whole case. When an

adult

> is given a general anesthetic, they have an IV. Diprivan( a

> pentothal-type drug) is used for induction of anesthesia, and

Versad

> and a narcotic are usually given. Anesthesia is maintained with

either

> of the gases Sevoflourane or Suprane. If the case is short we can

use

> just Diprivan given IV as the anesthetic. There are many ways to

do an

> anesthetic but this is just the basics.

>

> My advice if your child has to have an anesthetic is to ask to

speak to

> the anesthesia personnel before you go to the hospital. Stress to

them

> that your child has a B12 deficiency and to limit the use of

nitrous.

> Tell them there are reports of serious regressions after

anesthetics.

> If they cannot start an IV on your child, they can give nitrous

for

> just a few minutes and then turn it off, or not use it at all and

just

> give oxygen with the gas. In my practice I have stopped giving

> nitrous to my adults because of the link to nausea.

>

> About the MTHFR gene...well, we all cannot go out and get genetic

> testing, but we can assume we have a defect in folate metabolism.

Last

> year I started having numbness in my hands and face. The MRI was

> negative and no one could tell me what was wrong. From my own

research

> I thought it was from being exposed to the nitrous for over 20

years.

> I found that I got numbness when I would be in a room doing

children

> all day. Since then I avoid doing children. My doctor also put

me on

> folic acid for a high homocystine level. I am now also on B12.

> Unfortunately mainstream medicine does not link autism and B12.

They

> still think it is a deficiency of Ritallin or Resperidal.

> I hope this helps.

>

> Sym Rankin

> Mom to 5

>

> Arch Dis Child 2001;85:510 ( December )

>

> Letters to the editor

>

> Nitrous oxide and vitamin B12

>

> EDITOR,

> ----------

>

> The paper by Kanagasundaram et al1 on the use of nitrous oxide to

> alleviate pain and anxiety during painful procedures fails to

mention

> the effect of this gas on cobalamin metabolism. Nitrous oxide

> inactivates cob(I)alamin, the active derivative of vitamin B12 and

> essential cofactor for the transfer of the methyl group from

> methyltetrahydrofolate to homocysteine to form methionine. For

subjects

> with good body stores of cobalamin this effect is unimportant, but

> no-one using this agent should remain unaware of the potentially

> devastating complications in the nervous system of using nitrous

oxide

> in subjects who are of borderline or deficient vitamin B12 status.

> Onset of subacute combined degeneration affecting the brain and

spinal

> cord is a well documented event when individuals with low body

stores

> of cobalamin are exposed to nitrous oxide.2

>

> There is a long list of situations which put children at special

risk

> of cobalamin deficiency

> ----------

>

> for example, diets low in animal products, synthetic feeding of

any

> description, small bowel malfunction, any prolonged illness with

> disturbance of feeding behaviour, especially if combined with

increased

> metabolic demands

> ----------

>

> for example, systemic malignancy or chemotherapy. Children with

chronic

> conditions often need painful procedures, and depleted cobalamin

stores

> may not be apparent unless measurements of serum B12 are made

> routinely. What is more, repeated use of nitrous oxide depletes

the

> body stores of cobalamin even in well people.

>

> Given the scale of use which would result from routine use of

nitrous

> oxide in children undergoing painful procedures, there should be

real

> concern about the potential for an accident in a child with occult

> cobalamin deficiency. The message must be: never forget vitamin

B12

> when thinking of using nitrous oxide.

>

> ISABEL SMITH

> Clinical Audit Department, Great Ormond Street Hospital, Great

Ormond

> Street, London WC1N 3JH, smithi@g...

>

>

> References

>

>

>

> 1.

> Kanagasundaram SA, Lane LJ, Cavaletto BP, et al. Efficacy and

safety

> of nitrous oxide in alleviating pain and anxiety during painful

> procedures. Arch Dis Child 2001;84:492-495[Abstract/Free Full

Text].

>

> 2.

> Lee P, I, Piesowicz A, et al. Spastic parapareisis after

> anaesthesia. Lancet 1999;353:554[Medline].

>

> © 2001 by Archives of Disease in Childhood

hth

emma

>

>

>

> I remember there being a discussion about nitrous oxide for

anesthesia

> and regression in the past--but I didn't pay attention because my

son

> had had it in the past and had not had a problem with it....We're

> seeing major behavior issues/regression since his scope--and he

was

> given nitrous oxide and I am trying to figure out if there is a

> connection and where I can find more information. Would love any

> input.

>

> Thanks-

>

>

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