Nitrous Oxide

Illustration

Nitrous oxide is an anaesthetic gas. It is used during dental work and with patients who are not candidates for more commonly used anaesthetics during surgery.

Summary of Interactions with Vitamins, Herbs, and Foods
In some cases, a herb or supplement may appear in more than one category, which may seem contradictory. For clarification, read the full article for details about the summarized interactions.

Beneficial May Be Beneficial: Depletion or interference—The medication may deplete or interfere with the absorption or function of the nutrient. Taking these nutrients may help replenish them.

Folic acid

Vitamin B12
Beneficial May Be Beneficial: Side effect reduction/prevention—Taking these supplements may help reduce the likelihood and/or severity of a potential side effect caused by the medication.

Catechin*

Ginger*

Milk thistle*
Supportive interaction

None known
Reduced drug absorption/bioavailability

None known
Adverse interaction

None known

An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

Interactions with Dietary Supplements

Folic acid and Vitamin B12
Nitrous oxide interferes with activity of vitamin B12, which further interferes with the activity of folic acid, causing adverse actions.1 2 Administration of folic acid or folinic acid (activated folic acid) has reversed nitrous oxide-induced bone marrow changes.3 4 People with vitamin B12 deficiency may be especially susceptible.5 People who will undergo nitrous oxide anaesthesia for a few hours may benefit from vitamin B12 and folic acid supplementation.6 Some doctors recommend 100 mcg of vitamin B12 and 1,000 mcg folic acid, starting one week before through one week after prolonged exposure to nitrous oxide. People with normal vitamin B12 levels who undergo short-duration nitrous oxide anaesthesia (less than two hours) do not require supplementation.

Catechin
Some general anaesthetic drugs have infrequently caused liver damage. One animal study showed that taking catechin (a bioflavonoid) prior to halothane exposure reduced the amount of liver damage caused by the drug.7 Additional research is needed to determine whether this protective effect occurs in humans and with other general anaesthetics.

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Interactions with Herbs

Ginger  (Zingiber officinale)
General anaesthetics commonly cause nausea upon waking. In a double-blind study, taking 1 gram of ginger one hour before surgery was as effective at reducing nausea and vomiting as the anti-nausea drug metoclopramide.8 Individuals taking ginger in order to avoid side effects should disclose this to their doctor prior to surgery, since the herb might affect blood clotting.

Milk thistle (Silybum marianum)
Some general anaesthetic drugs have infrequently caused liver damage. One animal study showed that taking silybine, an active compound found in milk thistle, prior to halothane exposure reduced the amount of liver damage caused by the drug.9 Though controlled research in humans is necessary, some doctors of natural medicine currently suggest taking milk thistle standardised to contain 140 mg of silymarin three times a day, beginning a week before surgery and continuing for at least one week after surgery.

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References
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