Staubli Georg, Baumgartner Matthias, Sass Jörn Oliver, Hersberger Martin
From the *Department of Emergency Care, †Divisions of Metabolism, ‡Clinical Chemistry and Biochemistry, University Children's Hospital and Children's Research Center, Zurich, Switzerland.
Pediatr Emerg Care. 2016 Dec;32(12):827-829. doi: 10.1097/PEC.0000000000000582.
The efficiency of nitrous oxide in an equimolar mixture with oxygen or in concentrations up to 70% is approved for short painful procedures. Evaluation of the vitamin B12 levels in anesthetic staff applying nitrous oxide showed reduced vitamin B12 plasma levels. This study examines the vitamin B12 status of medical staff working with nitrous oxide in a pediatric emergency department (ED). Medical staff of the ED at the University Children's Hospital Zurich participated. The vitamin B12 status was evaluated by measuring homocysteine, methylmalonic acid, vitamin B12, blood count, and the MTHFR C677T genotype. As a control group, medical personnel working in the "nitrous oxide-free" pediatric intensive care unit were recruited.
The parameters for the vitamin B12 status of all participants were in the reference range, and there were no significant differences for the 2 groups. By trend, the ED staff showed higher vitamin B12 levels. The ED staff members were slightly older (P = 0.07) and had higher hemoglobin levels (P < 0.04) compared with the pediatric intensive care unit staff.
The use of nitrous oxide (50%-70%) with a demand valve is safe for the vitamin B12 status of medical personnel in the ED.
氧化亚氮与氧气的等摩尔混合物或浓度高达70%的氧化亚氮在短时间疼痛手术中的有效性已获批准。对使用氧化亚氮的麻醉工作人员的维生素B12水平评估显示血浆维生素B12水平降低。本研究调查了苏黎世大学儿童医院儿科急诊科使用氧化亚氮的医务人员的维生素B12状况。苏黎世大学儿童医院急诊科的医务人员参与了研究。通过测量同型半胱氨酸、甲基丙二酸、维生素B12、血细胞计数和MTHFR C677T基因型来评估维生素B12状况。作为对照组，招募了在“无氧化亚氮”的儿科重症监护病房工作的医务人员。
所有参与者的维生素B12状况参数均在参考范围内，两组之间无显著差异。从趋势上看，急诊科工作人员的维生素B12水平较高。与儿科重症监护病房工作人员相比，急诊科工作人员年龄稍大（P = 0.07），血红蛋白水平较高（P < 0.04）。
在急诊科，使用带有按需阀的氧化亚氮（50%-70%）对医务人员的维生素B12状况是安全的。
