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Yet, the behavioral effects of cold and inert gas narcosis have commonly been assessed in isolation and during short-term provocations. We therefore evaluated the interactive influence of mild hypothermia and narcosis engendered by a subanesthetic dose of nitrous oxide (N<jats:sub>2<\/jats:sub>O; a normobaric intervention analog of hyperbaric nitrogen) on cognitive function during prolonged iterative exposure. Fourteen men partook in two \u223c12-h sessions (separated by \u22654 days), wherein they performed sequentially three 120-min cold (20\u00b0C) water immersions (CWIs), while inhaling, in a single-blinded manner, either normal air or a normoxic gas mixture containing 30% N<jats:sub>2<\/jats:sub>O. CWIs were separated by a 120-min rewarming in room-air breathing conditions. Before the first CWI and during each CWI, subjects performed a finger dexterity test, and the Spaceflight Cognitive Assessment Tool for Windows (WinSCAT) test assessing aspects of attention, memory, learning, and visuospatial ability. Rectal and skin temperatures were, on average, reduced by \u223c1.2\u2009\u00b0C and \u223c8\u2009\u00b0C, respectively ( P &lt; 0.001). Cooling per se impaired ( P \u2264 0.01) only short-term memory (\u223c37%) and learning (\u223c18%); the impairments were limited to the first CWI. N<jats:sub>2<\/jats:sub>O also attenuated ( P \u2264 0.02) short-term memory (\u223c37%) and learning (\u223c35%), but the reductions occurred in all CWIs. Furthermore, N<jats:sub>2<\/jats:sub>O invariably compromised finger dexterity, attention, concentration, working memory, and spatial processing ( P &lt; 0.05). The present results demonstrate that inert gas narcosis aggravates, in a persistent manner, basic and higher-order cognitive abilities during protracted cold exposure. <\/jats:p>","DOI":"10.1152\/ajpregu.00246.2023","type":"journal-article","created":{"date-parts":[[2024,1,8]],"date-time":"2024-01-08T09:44:53Z","timestamp":1704707093000},"page":"R197-R209","update-policy":"https:\/\/doi.org\/10.1152\/aps-crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Combined effects of mild hypothermia and nitrous-oxide-induced narcosis on manual and cognitive performance"],"prefix":"10.1152","volume":"326","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-2780-5259","authenticated-orcid":false,"given":"Maaike I.","family":"Moes","sequence":"first","affiliation":[{"name":"Division of Environmental Physiology, Swedish Aerospace Physiology Center, KTH Royal Institute of Technology, Stockholm, 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