Ezzelarab Nosaiba K, Matar Tarek
Anaesthesia, King's College Hospital NHS Foundation Trust, London, GBR.
Neurology, University Hospitals Sussex NHS Foundation Trust, Brighton, GBR.
Cureus. 2025 Aug 1;17(8):e89232. doi: 10.7759/cureus.89232. eCollection 2025 Aug.
Recreational use of nitrous oxide (NO) ("hippy crack") has increased in recent years, with serious complications being reported, including airway cold injuries, neurological disease, and thrombotic events. This review highlights the perioperative implications of NO misuse, with a focus on airway injury, neurological sequelae, and anaesthetic management. Cold burns from direct inhalation can compromise airway safety, while chronic use leads to functional vitamin B12 inactivation, resulting in subacute combined degeneration and peripheral neuropathy. In such patients, intraoperative use of NO may exacerbate existing complications. Clinicians should maintain a high index of suspicion for NO misuse, avoid its administration during anaesthesia, and consider early referral for neurological assessment and substance misuse support.
近年来，氧化亚氮（NO）（“嬉皮士可卡因”）的娱乐性使用有所增加，有报道称出现了严重并发症，包括气道冷损伤、神经疾病和血栓形成事件。本综述强调了氧化亚氮滥用对围手术期的影响，重点关注气道损伤、神经后遗症和麻醉管理。直接吸入造成的冷灼伤会危及气道安全，而长期使用会导致功能性维生素B12失活，从而引起亚急性联合变性和周围神经病变。在此类患者中，术中使用氧化亚氮可能会加重现有并发症。临床医生应高度怀疑氧化亚氮滥用情况，避免在麻醉期间使用，并考虑尽早转诊进行神经评估和药物滥用支持。
