Pernicious Anaemia Society

Nitrous oxide question

Hello,

What would happen if I were to have an accident (say a broken leg), and was offered nitrous oxide for pain relief? I know it can deplete B12 stores but is that still an issue when receiving B12 injections? Would it be a case of asking for alternative pain relief or would it just require extra B12 to top it up again?

This occurred to me when watching that Ambulance programme on the TV. I did think if I was in total agony I would be inclined to take the gas and damn the consequences!- but what would be the correct plan for such an event?

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Hi Curlygal I think it is only if one has an absorption problem and couldn't naturally replace the "oxidised" B12 with new B12. Having cobamalin injections would resolve that.

I'm not medically trained but there are others on here who will be able to help.

Keep safe

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nitrous oxide reacts with the B12 in your blood meaning that it is converted to a form that your body can't use.

Whilst a B12 shot will replace this deactivated B12, the nitrous oxide could cause problems in the period to the next B12 shot, so ideally it is a painkiller that you should avoid

- how much of an effect it would have is likely to depend on the amounts still in your blood from the last B12 shot.

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Hi,

Link about nitrous oxide

gov.uk/drug-safety-update/n...

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Thanks for that link Sleepybunny - can show it to any doctors who aren't aware of the interaction.

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I would hope your GP would give you a make-up B12 injection, but being a cynic, probably not.

I had an operation recently and told the anaesthetist I had B12 deficiency, he thanked me for telling him and made a note not to use nitrous oxide and used another anaesthetic.

Perhaps there would be another painkiller they could offer.

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It's good the anaesthetist was aware of the connection with B12. I would definitely bring it up for a planned procedure. I'm more worried about an acute incident though. They usually give morphine only after trying nitrous oxide, don't they? Just wouldn't want to be stuck in pain in that circumstance!

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I had a fall a few years ago at home and had to be hospitalised with a broken ankle. I was offered morphine without being offered nitrous oxide first. I doubt that they would administer painkillers to a patient that was unconscious or confused so you would be asked to make a decision one way or the other.

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Yes it is a difficult one. Hope you don't find it necessary.

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