title: Asphyxial deaths from the recreational use of nitrous oxide.
abstract: The recreational use of nitrous oxide is widespread. Nitrous oxide for recreational use is usually obtained from anesthesia tanks or whipped-cream machine chargers or cans. Twenty previously described deaths associated with recreational nitrous-oxide use describe anesthesia tanks and whipped-cream machine dispensors as a source. Five deaths associated with nitrous oxide use are presented; two involving whipped-cream cannisters as the source, two involving anesthesia tanks, and one involving a racing fuel tank as a source of nitrous oxide. Autopsy findings in our cases were subtle or negative, but usually suggestive of asphyxia. Through a laboratory simulation, we have confirmed that nitrous oxide displaces oxygen in a closed space, which probably leads to asphyxia. A review of the literature, neuropharmacology, and pathophysiology of nitrous oxide use is also presented.
authors.affiliation: Department of Pathology, Indiana University School of Medicine.
authors.forename: S A
authors.initials: SA
authors.lastname: Wagner
authors.forename: M A
authors.initials: MA
authors.lastname: Clark
authors.forename: D L
authors.initials: DL
authors.lastname: Wesche
authors.forename: D J
authors.initials: DJ
authors.lastname: Doedens
authors.forename: A W
authors.initials: AW
authors.lastname: Lloyd
mesh_terms: D000293:Adolescent; D000328:Adult; D000336:Aerosols; D001237:Asphyxia / Q000209:etiology* / Q000401:mortality; D002423:Cause of Death; D006801:Humans; D008297:Male; D008875:Middle Aged; D009609:Nitrous Oxide / Q000378:metabolism; D010100:Oxygen / Q000378:metabolism; D019966:Substance-Related Disorders / Q000401:mortality*
chemical_list: D000336:Aerosols; D009609:Nitrous Oxide; D010100:Oxygen