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Sci Data 2022 Jun 24;9(1):361. Epub 2022 Jun 24.

National Institute of Standards and Technology, Gaithersburg, MD, USA.

Urban regions emit a large fraction of anthropogenic emissions of greenhouse gases (GHG) such as carbon dioxide (CO) and methane (CH) that contribute to modern-day climate change. As such, a growing number of urban policymakers and stakeholders are adopting emission reduction targets and implementing policies to reach those targets. Over the past two decades research teams have established urban GHG monitoring networks to determine how much, where, and why a particular city emits GHGs, and to track changes in emissions over time. Read More

Clin Sci (Lond) 2022 Jun 22. Epub 2022 Jun 22.

Second Affiliated Hospital of Anhui Medical University, Hefei, China.

Osteoarthritis (OA) is a heterogeneous condition characterised by cartilage degradation, subchondral sclerosis, and osteophyte formation, and accompanied by the generation of pro-inflammatory mediators and degradation of extracellular matrix. The current treatment for early OA is focused on the relief of symptoms, such as pain, but this treatment cannot delay the pathological process. L-Glutamine (L-Gln), which has anti-inflammatory and anti-apoptotic effects, is the most abundant amino acid in human blood. Read More

S D Med 2022 Mar;75(3):109-113

University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota.

Introduction: The use of minimal and moderate sedation in the pediatric population allows for the successful completion of many procedures in both hospital and outpatient settings without the risks involved with general anesthesia. Sanford Children's outpatient sedation clinic had been using oral midazolam for minimal sedation but began using inhaled nitrous oxide in January 2019. The current study examines patient experience and parent/guardian satisfaction with use of inhaled nitrous oxide for minimal sedation. Read More

Eur Arch Paediatr Dent 2022 Jun 2. Epub 2022 Jun 2.

Peoples College of Dental Sciences, Bhopal, India.

Aim: There is skepticism amongst many dentists about the interference of nitrous oxide with the physiological parameters. This commentary attempts to make clear recommendations on the use of pulse oximeter during nitrous oxide inhalation sedation.

Background: Nitrous oxide is used commonly in dentistry as a tool to reduce fear/ anxiety and build a positive dental attitude. Read More

Orthop J Sports Med 2022 May 12;10(5):23259671221096095. Epub 2022 May 12.

Cedars-Sinai Kerlan-Jobe Institute, Los Angeles, California, USA.

Background: Thumb injuries are common in baseball players and can sometimes be challenging to effectively manage. A subset of patients experience failed nonoperative management yet do not have a clear indication for surgery. Cryoneurolysis or cryoanalgesia is a form of neuromodulation for pain that has been approved by the US Food and Drug Administration; it has been used safely and effectively on a variety of peripheral nerves. Read More

Am J Emerg Med 2022 Jun 23;56:92-99. Epub 2022 Mar 23.

Department of Stomatology, the 960th hospital of People's Liberation Army of China (PLA), Jinan, China. Electronic address:

Background: Nitrous oxide (NO) has a rapidly analgesic effect, but evidence regarding its role in managing pain in adults in the emergency department (ED) is conflicting. The purpose of this meta-analysis is to investigate the analgesic efficacy and safety of NO in adults in ED.

Methods: We systematically searched PubMed, the Cochrane Library, Embase, Web of science, China National Knowledge Infrastrusture (CNKI) and Wanfang Database up to August 10th, 2021. Read More

Int Emerg Nurs 2022 05 29;62:101158. Epub 2022 Mar 29.

Department of Nursing, College of Applied Medical Sciences, King Faisal University, Al-Ahsa, Saudi Arabia.

Objective: To systematically review the available data and scientific literature and to compile all evidence-related studies of the effectiveness of pain management for traumatic patients in the emergency department.

Methods: The present study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.

Results: A total of 777 articles were retrieved, and eighteen were selected according to the inclusion criteria in this systemic review. Read More

Brain Behav 2022 04 20;12(4):e2533. Epub 2022 Mar 20.

Department of Neurology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China.

Purpose: To review the clinical symptoms, auxiliary examination findings, and outcomes of patients with nitrous oxide (N O) abuse, and analyze the factors that affect outcomes.

Methods: Patients with N O abuse treated in the Department of Neurology between January 2018 and December 2020 were included. The clinical data of these patients were collected, and follow-up was conducted to determine the outcomes. Read More

Pediatr Blood Cancer 2022 Aug 10;69(8):e29598. Epub 2022 Mar 10.

Cancer and Blood Disorders, the Design and Analytics Programs, Minneapolis, Minnesota, USA.

Background: Childhood acute lymphoblastic leukemia (ALL) treatment requires numerous lumbar punctures (LPs) with intrathecal (IT) chemotherapy to prevent and treat central nervous system disease. Historically, LPs in this setting are performed using propofol sedation at most institutions. At our center, LPs are often alternatively performed under nitrous oxide (N O). Read More

Lakartidningen 2022 02 8;119. Epub 2022 Feb 8.

specialist i neurologi, Neurologen, Sahlgrenska universitetssjukhuset, Göteborg.

A 19 year old male presented to his GP with bilateral numbness and stiffness of hands and lower limbs, as well as muscle weakness and poor balance. The patient admitted recreational use of nitrous oxide (laughing gas) some days earlier. He was hospitalised and underwent a series of plasmapheresis treatments due to an initial suspicion of inflammatory myelitis. Read More

J Anesth 2022 Jun 9;36(3):436-440. Epub 2022 Feb 9.

Department of Anesthesiology, Fukushima Medical University School of Medicine, 1, Hikariga-oka, Fukushima, 960-1297, Japan.

Dopamine D and acetylcholine M receptors might be related to post-operative cognitive dysfunction. The aim of the present study is to investigate whether several anesthetics which are used for general anesthesia and/or sedation, affect expression of dopamine D and acetylcholine M receptors in the rat brain. Thirty-six male rats aged 5-9 weeks old were divided into six groups (n = 6 in each group); five groups for anesthetics and one for control. Read More

Pain 2021 Dec 20. Epub 2021 Dec 20.

Inserm U987, APHP, CHU Ambroise Paré, UVSQ, Paris-Saclay, Boulogne-Billancourt, France CETD, CHU Cochin, APHP, Paris-Descartes University, Inserm U987, Paris, France Air Liquide Santé International, Les Loges en Josas, France Department of Neurology, University of Würzburg, Würzburg, Germany.

Abstract: Experimental studies have suggested that nitrous oxide-induced analgesia depends on interactions with opioids. On the basis of these results, we hypothesized that the effects of inhaled nitrous oxide/oxygen (N2O/O2) 50%-50% equimolar mixture (EMONO) on patients with neuropathic pain would be higher in those receiving concomitant opioids. To test this hypothesis, we did exploratory post hoc analyses of our recently published ProtoTOP study to compare the effects of EMONO and placebo in patients with or without concomitant opioid treatment. Read More

Medicine (Baltimore) 2022 Jan;101(1):e28474

Regional Coordination of Rare Diseases (CoReMaR), Apulia Regional Agency for Health and Social Care (AReSS), Bari, Italy.

Rationale: Epidermolysis bullosa (EB) is an inherited disease characterized by fragile skin with painful blistering, which requires lifelong skin and wound care. This case report describes the use of inhaled nitrous oxide (N2O) for procedural pain control at home during wound care in a young man with severe dystrophic EB. To our knowledge, only 1 case was reported by Ingelmo et al in 2017 regarding the use of N2O at home in a 4-year-old-child. Read More

Paediatr Anaesth 2022 Apr 3;32(4):548-555. Epub 2022 Feb 3.

Faculty of Medicine & Dentistry, School of Dentistry, University of Alberta, Edmonton, Alberta, Canada.

Background: Moderate sedation using nitrous oxide (N O) has become common in pediatric dentistry. However, less is known regarding the role of patients' characteristics and psychosocial factors in their cooperative behavior during dental procedures with N O.

Aims: This study aimed to examine pediatric dental patients' behaviors while undergoing N O sedation and to measure the associations between child's cooperative behavior and demographic, physiological responses, and psychosocial factors. Read More

J Neurol Sci 2022 Mar 16;434:120092. Epub 2021 Dec 16.

Department of Psychiatry, Washington University School of Medicine, Saint Louis, MO, United States of America. Electronic address:

Stemming from the results of the historic STAR-D trial, it is evident that a significant subset of individuals (20-25%) with major depressive disorder (MDD) do not respond to conventional antidepressant medications. As a result, an emphasis has been placed on the development of novel therapeutics for MDD over the last two decades. Recently, substantial research efforts have been focused on the use of ketamine as an antidepressant whose mechanism of action is via the N-methyl-d-aspartate (NMDA) receptor. Read More

Pediatr Dent 2021 Nov;43(6):457-462

Dr. Warren is pediatric dentistry resident, Program for Advanced Pediatric Dental Education, Bon Secours St Mary's Hospital, Richmond, Va., USA.

The purpose of this study was to compare the effectiveness of intranasal dexmedetomidine (DEX), oral midazolam (MID), and oral midazolam combined with oral hydroxyzine (MIDHYD) with nitrous oxide when used for sedation during pediatric dental procedures. The charts of 146 patients who underwent dental procedures using moderate sedation with DEX, MID, or MIDHYD, all with nitrous oxide, from January 2014 to December 2019, were reviewed retrospectively. Sedations were evaluated for effectiveness based on sedation level and behavior using a modified University of Michigan Sedation Scale and behavior using the American Academy of Pediatric Dentistry sedation behavior scale. Read More

Anesth Analg 2022 Jun 20;134(6):1126-1139. Epub 2021 Dec 20.

From the Department of Anesthesiology.

Background: Neurophysiologic complexity has been shown to decrease during states characterized by a depressed level of consciousness, such as sleep or anesthesia. Conversely, neurophysiologic complexity is increased during exposure to serotonergic psychedelics or subanesthetic doses of dissociative anesthetics. However, the neurochemical substrates underlying changes in neurophysiologic complexity are poorly characterized. Read More

Prehosp Emerg Care 2022 Jan 25:1-10. Epub 2022 Jan 25.

Colorado Springs Fire Department, Colorado Springs, Colorado, USA.

This project sought to develop evidence-based guidelines for the administration of analgesics for moderate to severe pain by Emergency Medical Services (EMS) clinicians based on a separate, previously published, systematic review of the comparative effectiveness of analgesics in the prehospital setting prepared by the University of Connecticut Evidence-Based Practice Center for the Agency for Healthcare Research and Quality (AHRQ). A technical expert panel (TEP) was assembled consisting of subject matter experts in prehospital and emergency care, and the development of evidence-based guidelines and patient care guidelines. A series of nine "patient/population-intervention-comparison-outcome" (PICO) questions were developed based on the Key Questions identified in the AHRQ systematic review, and an additional PICO question was developed to specifically address analgesia in pediatric patients. Read More

Cureus 2021 Nov 8;13(11):e19377. Epub 2021 Nov 8.

Internal Medicine, Michigan State University, Lansing, USA.

There is rising use of recreational nitrous oxide (N₂O) in the community because of its availability as "whippet" canisters. Nitrous oxide use is still legal and outside the purview of the Drug Enforcement Administration (DEA). It is not detected on a routine drug screen, and patient history is key to establishing the diagnosis. Read More

Rev Med Interne 2022 Mar 10;43(3):170-177. Epub 2021 Dec 10.

Centre antipoison de Paris - Fédération de toxicologie de l'AP-HP, Hôpital Lariboisière-Fernand-Widal (AP-HP), 75010 Paris, France; Inserm UMR S-1144, Faculté de pharmacie, 75006 Paris, France; UFR de médecine, Université de Paris, 75006 Paris, France. Electronic address:

Nitrous oxide (NO) is used since the eighteenth century as an anesthetic and analgesic but also for recreational use. If the labelled uses of NO and their modalities are nowadays perfectly framed, the misuse of NO takes very alarming proportions among teenagers and young adults. This misuse is the cause of acute (hypoxia, barotrauma, burns, neuropsychiatric disorders) and chronic complications if repeated (myeloneuropathy, anemia, thrombosis, inhalant use disorder). Read More

BMJ 2021 11 26;375:n2922. Epub 2021 Nov 26.

Sci Total Environ 2022 Jan 10;804:150225. Epub 2021 Sep 10.

Key Laboratory of Ecosystem Network Observation and Modeling, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China. Electronic address:

Forest thinning is a major forest management practice worldwide and may lead to profound alterations in the fluxes of soil greenhouse gases (GHGs). However, the global patterns and underlying mechanisms of soil GHG fluxes in response to forest thinning remain poorly understood. Here, we conducted a global meta-analysis of 106 studies to assess the effects of forest thinning on soil GHG fluxes and the underpinning mechanisms. Read More

Eur J Anaesthesiol 2021 12;38(12):1230-1241

From the Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Department of Anaesthesiology (AW, HI, JP, JS), Department of Orthopaedic and Trauma Surgery, Erlangen, Germany (MB), Médical R&D, Air Liquide Santé International, Les Loges-en-Josas, France (NN, JFRG, BB).

Background: Remifentanil is an effective drug in peri-operative pain therapy, but it can also induce and aggravate hyperalgesia. Supplemental administration of N2O may help to reduce remifentanil-induced hyperalgesia.

Objective: To evaluate the effect of 35 and 50% N2O on hyperalgesia and pain after remifentanil infusion. Read More

Dent Traumatol 2022 Apr 26;38(2):156-159. Epub 2021 Oct 26.

Pediatric Emergency Department, Rambam Health Care Campus, Haifa, Israel.

There is a paucity of data regarding the safety of the practice of sedation for oro-dental trauma in paediatric emergency departments (ED). A previous study reported the safety of intramuscular ketamine administered as a single agent. In the paediatric ED of a tertiary trauma centre in Israel, one of two ketamine-based regimens is used for sedating children with intraoral injuries according to the physician's discretion: a single dose of intramuscular ketamine or a combination of ketamine and propofol (KP) intravenously. Read More

Environ Sci Pollut Res Int 2022 Mar 20;29(12):17530-17543. Epub 2021 Oct 20.

Department of Management, College of Business Administration, King Saud University, P.O. Box 71115, Riyadh, 11587, Saudi Arabia.

The coronavirus disease (COVID-19) is a highly transmitted disease that spreads all over the globe in a short period. Environmental pollutants are considered one of the carriers to spread the COVID-19 pandemic through health damages. Carbon emissions, PM2. Read More

Anaesthesist 2022 03 18;71(3):233-242. Epub 2021 Oct 18.

Karl Landsteiner Institut für Notfallmedizin, Corvinusring 3-5, 2700, Wiener Neustadt, Österreich.

Treatment of acute pain is a central task in emergency medicine. Yet, prehospital pain relief is often insufficient or delayed since the administration of potent intravenous analgesic drugs (such as opioids) is mostly limited to physicians due to legal restrictions or training deficiencies in Germany and Austria. Frequently, prehospitally operating emergency physicians have to be demanded later for anguished patients limiting disposability of physicians for patients who are in a potentially life-threatening condition. Read More

Philos Trans A Math Phys Eng Sci 2021 Nov 27;379(2210):20200457. Epub 2021 Sep 27.

NCAS, Department of Chemistry, University of Cambridge, Lensfield Road, Cambridge CB2 1EW, UK.

The causes of methane's renewed rise since 2007, accelerated growth from 2014 and record rise in 2020, concurrent with an isotopic shift to values more depleted in C, remain poorly understood. This rise is the dominant departure from greenhouse gas scenarios that limit global heating to less than 2°C. Thus a comprehensive understanding of methane sources and sinks, their trends and inter-annual variations are becoming more urgent. Read More

Environ Pollut 2021 Dec 13;291:118154. Epub 2021 Sep 13.

Department of Rural and Bio-systems Engineering (Brain Korea 21), Chonnam National University, Gwangju, 61186, Republic of Korea; AgriBio Institute of Climate Change Management, Chonnam National University, Gwangju, 61186, Republic of Korea. Electronic address:

Global meta-analyses showed that biochar application can reduce NO emission. However, no relevant review study is available for East Asian countries which are responsible for 70% of gaseous N losses from croplands globally. This review analyzed data of the biochar-induced NO mitigation affected by experimental conditions, including experimental types, biochar types and application rates, soil properties, and chemical forms and application rates of N fertilizer for East Asian countries. Read More

Anesth Analg 2022 02;134(2):294-302

College of Nursing, Department of Nurse Midwives, University of Colorado Anschutz Medical Campus, Aurora, Colorado.

Background: Nitrous oxide (N2O) has been used nationally as an analgesic in many clinical settings. While neuraxial analgesia is still the most commonly used labor analgesic in the United States, there is increasing use of N2O in labor. Given the reduction in the partial pressure of gases at a higher altitude, N2O has been reported to have reduced analgesic properties. Read More

Int Arch Occup Environ Health 2021 11 23;94(8):1773-1782. Epub 2021 Aug 23.

Department of Mechanical Engineering, University of Canterbury, Private Bag 4800, Christchurch, 8140, New Zealand.

Objective: Nitrous oxide (Entonox) and methoxyflurane (Penthrox) are inhaled analgesics administered in paramedicine. Occupational exposure to nitrous oxide has been associated with negative health effects, and may inhibit professional capability. The effect of occupational exposure to methoxyflurane has not yet been clearly determined. Read More