In March 4, British health authorities announced plans to criminalize the possession and use of nitrous oxide (N2O) as laughing gas. This decision goes against the recommendations of the group of experts who had, a month earlier, refuted the use of prohibition in an editorial in the British Medical Journal. In France, sales to minors have been prohibited since 2021 and consumption on public roads is prohibited in several metropolitan areas.
Nitrous oxide was discovered and synthesized in the XVIIIe century in Britain. The first “proto parts” date back to 1799, when English society inhaled this gas for its hilarious and disinhibiting effects. It became, fifty years later, an analgesic product used with ether for the first general anesthesias.
It is a natural gas emitted mainly by soil decomposition, nitrogen fertilizers, the oceans, animal waste; it is also produced industrially for the manufacture, among other things, of propellant gas for whipped cream siphons. It is this last use that is the subject of recreational diversion, thanks to small cartridges of N2Pure O transferred to a balloon, then inhaled.
Its consumption is booming for several reasons: its availability over the counter in stores and on the Internet, its reduced cost and the arrival on the market of carboys containing the equivalent of 80 cartridges (640 grams). This diverted use of pure gas can lead to serious adverse effects, in particular neurological ones, which are mostly reversible after vitamin B12 supplementation. They concern only the rare misuses with massive and prolonged consumption of N2O (about 10 cartridges of 8 grams per day, for several weeks).
However, nitrous oxide mixed with oxygen, Meopa, has revolutionized the management of painful care in France. It all started in 1992, when we presented the first videos to Unesco showing the beneficial effects of Meopa on leukemia children at Trousseau Hospital (Paris). For many teams, it was a real shock to see for the first time lumbar punctures, marrow samples taken from smiling children, in the presence of the parents and, above all, without physical restraint.
In less than five years, the majority of pediatric oncohematology departments adopted this method. France has thus become one of the leading countries in the use of Meopa. All pediatric departments as well as emergencies now have it and use it daily, adults and the elderly can also benefit from it.
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