Effect of nitrous oxide exposure during surgery on the homocysteine concentrations of children

Anesthesiology
Dubraiicka PichardoDeborah L O'Connor

Abstract

Nitrous oxide converts vitamin B12 to its nonmetabolically active form, inhibits methionine synthase, and results in an elevation of plasma total homocysteine (tHcy). The authors investigated the effect of nitrous oxide anesthesia on the plasma tHcy concentrations in children the morning after surgery and whether blood concentrations of folate and vitamins B12 and B6 were associated with any potential increase. The authors measured plasma tHcy concentrations in 32 children before and 24 h after initial exposure to nitrous oxide (≥ 2 h). Genotype for methylenetetrahydrofolate reductase C677T and blood concentrations of folate, vitamins B12 and B6, and methylmalonic acid were measured before surgery. The median age of participants was 11 months (3-126 months). The median (first, third quartile) postoperative plasma tHcy concentration was significantly higher than the preoperative concentration (6.4 [4.7, 8.9] vs. 5.1[4.1, 6.4] μM, P < 0.0001), a 25% (2%, 42%) relative increase. Six of 28 (21%) children with normal, age-appropriate, preexposure plasma tHcy concentrations had postoperative plasma tHcy concentrations greater than the cutoff values. The duration of nitrous oxide exposure was associated positively with the rise in pla...Continue Reading

References

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Citations

Jun 27, 2013·British Journal of Anaesthesia·K de Vasconcellos, J R Sneyd
Oct 29, 2013·Journal of Anesthesia·Hanjo KoRichard D Urman
Feb 22, 2013·Current Opinion in Anaesthesiology·Nils Schallner, Ulrich Goebel
Sep 13, 2012·Paediatric Anaesthesia·Victor C BaumBruno Marciniak
Feb 7, 2015·Anesthesia and Analgesia·Andreas DumaPeter Nagele
Jan 10, 2014·Anesthesiology·Philip J Peyton, Christine Yx Wu
May 10, 2012·Anesthesiology·Peter Nagele
Jul 24, 2014·Seminars in Cardiothoracic and Vascular Anesthesia·Robert H Friesen
Dec 17, 2016·Anesthesia and Analgesia·Benjamin Kloesel, Robert S Holzman
Nov 2, 2019·Paediatric Anaesthesia·Victoria J ForsterChristina Halsey
May 11, 2018·Journal of Dental Anesthesia and Pain Medicine·Seong In Chi

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