Regularly referred to
as ‘laughing gas’, it’s increasing abuse has led to hospitalization
and deaths described in published case reports after accidental
inhalation [1], occupational exposure [2–4], post-operative effects
[5–8] and inhalation abuse [9–13]. It is understood that the toxic
effects associated with N2O are caused by the interaction with
vitamin B12 or the B12 coenzyme. Irreversible oxidation of the
central cobalt ion inactivates the vitamin and leads to inhibition of the methionine synthase and the N-methyl-d-aspartate (NMDA)
glutamate receptor [7,14