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¿Es el óxido nitroso un anestésico peligroso para los sujetos con deficiencia de vitamina B12?
JAMA
|March 28, 1986
Resumen
La anestesia con óxido nitroso puede desencadenar una grave degeneración de la médula espinal en personas con deficiencia oculta de vitamina B12. El diagnóstico y el manejo rápidos son cruciales para prevenir el daño neurológico irreversible.
Área de la Ciencia:
- Neurología Neurología.
- Anestesiología Anestesiología.
- Ciencias de la Nutrición Ciencias de la Nutrición
Sus antecedentes:
- La degeneración combinada subaguda de la médula espinal es una condición neurológica grave.
- La deficiencia de vitamina B12 es una causa conocida de disfunción neurológica.
- El óxido nitroso es un agente anestésico de uso común.
Objetivo del estudio:
- Informar de dos casos de disfunción neurológica después de la anestesia con óxido nitroso.
- Investigar el papel de la deficiencia de vitamina B12 en estos casos.
- Postular el vínculo entre el óxido nitroso y la enfermedad neurológica relacionada con la deficiencia de vitamina B12.
Principales métodos:
- Informe de caso de dos pacientes.
- Evaluación clínica de la disfunción neurológica.
- Investigación bioquímica para los niveles de vitamina B12.
- Revisión de la historia clínica del paciente.
Principales resultados:
- Ambos pacientes desarrollaron degeneración combinada subaguda de la médula espinal dentro de las ocho semanas de la anestesia con óxido nitroso.
- Se identificó una deficiencia preclínica o enmascarada de vitamina B12 en ambos pacientes.
- Un paciente tenía antecedentes de enfermedad de Crohn con resecciones ileal, el otro tenía anemia perniciosa.
Conclusiones:
- La anestesia con óxido nitroso puede precipitar o exacerbar la enfermedad neurológica en personas con deficiencia subyacente de vitamina B12.
- Se recomienda la detección de deficiencia de vitamina B12 en pacientes en riesgo antes de la anestesia con óxido nitroso.
- Esto pone de relieve la interacción crítica entre los agentes anestésicos y el estado nutricional.
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