Garbaz L, Mispelaere D, Boutemy M, Jounieaux V
Service de pneumologie et réanimation respiratoire, CHU Amiens, France.
Rev Mal Respir. 2007 May;24(5):622-4. doi: 10.1016/s0761-8425(07)91130-4.
A 21 year old man was admitted to hospital as an emergency complaining of left sided chest pain. Chest radiograph revealed a complete non compressive left-sided pneumothorax which resolved following thoracic drainage. A more detailed history revealed repeated and regular use of nitrous oxide by inhalation, for its consciousness-altering effect during rave parties.
The principal side effects occurring as a consequence of repeated exposures to nitrous oxide are haematological, neuropsychiatric and teratogenic. Rare cases of pneumothorax have been described associated with the use of nitrous oxide occurring as complications of anaesthesia or during laparoscopy where gas diffuses from the abdominal to the pleural cavity. Illicit use of nitrous oxide is rare and usually occurs in medical workers. Its spreading to the public may lead to accidents and unanticipated side effects.
Inhaled nitrous oxide can reveal asymptomatic pneumothorax by worsening it. The consequences can be dramatic in case of illicit use because of ignorance of side effects.
一名21岁男性因左侧胸痛急诊入院。胸部X光片显示为完全性非压迫性左侧气胸，经胸腔引流后气胸消失。进一步详细询问病史发现，该患者在锐舞派对期间因一氧化二氮具有改变意识的作用而反复且规律地吸入该气体。
反复接触一氧化二氮产生的主要副作用涉及血液学、神经精神方面以及致畸性。曾有罕见病例报道，一氧化二氮的使用与气胸有关，这些气胸作为麻醉并发症出现，或在腹腔镜检查期间发生，此时气体从腹腔扩散至胸腔。一氧化二氮的非法使用较为罕见，通常发生在医护人员中。其在公众中的传播可能导致事故及意外副作用。
吸入一氧化二氮可使无症状气胸病情加重。由于对副作用的无知，非法使用一氧化二氮的后果可能很严重。
