{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T14:20:02Z","timestamp":1758637202167},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,6,16]],"date-time":"2021-06-16T00:00:00Z","timestamp":1623801600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,6,16]],"date-time":"2021-06-16T00:00:00Z","timestamp":1623801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Anesthesiol"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Megaloblastic anemia or bone marrow changes could occur after prolonged nitrous oxide inhalation via vitamin B<jats:sub>12<\/jats:sub> inactivation related DNA synthesis impairment. Previous researches have studied hematological changes with nitrous oxide exposure, but only in adults or adolescents. Pre-school age children with active hematopoietic red bone marrow are more vulnerable to potential side effects of nitrous oxide and might experience growth impairment. The purpose of our study was to analyze red blood cell morphology changes under nitrous oxide anesthesia in pre-school age children.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>One hundred thirty-six children under 5\u2009years old scheduled for hemivertebra resection were analyzed. According to fresh gas type in anesthesia records, 71 children who received nitrous oxide in oxygen during anesthesia maintenance were categorized into the nitrous oxide group and the other 65 who received air in oxygen were the air group. Complete blood counts in perioperative period were assessed for anemia, macrocytosis, microcytosis, anisocytosis, hyperchromatosis and hypochromatosis. The peak value and change percentage were calculated for mean corpuscular volume and red cell distribution width.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Forty-two children in the air group (64.6%) and 30 in the nitrous oxide group (42.3%) developed anemia (<jats:italic>P<\/jats:italic>\u2009=\u20090.009). None developed macrocytosis in both groups. Postoperative mean corpuscular volume peaked (mean [95% confidence interval]) at 83.7(82.9\u201384.4) fL, and 83.2(82.4\u201383.9) fL and postoperative red cell distribution width at 13.8% (13.4\u201314.2%), and 13.9% (13.6\u201314.2%) for the air group and the nitrous oxide group. Both the relative change of mean corpuscular volume (<jats:italic>P<\/jats:italic>\u2009=\u20090.810) and red cell distribution width (<jats:italic>P<\/jats:italic>\u2009=\u20090.456) were similar between the two groups.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>No megaloblastic red blood cell changes were observed with nitrous oxide exposure for 4\u2009h in pre-school age children undergoing hemivertebra resection.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12871-021-01388-5","type":"journal-article","created":{"date-parts":[[2021,6,16]],"date-time":"2021-06-16T06:12:49Z","timestamp":1623823969000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A retrospective cohort study on red blood cell morphology changes in pre-school age children under nitrous oxide anesthesia"],"prefix":"10.1186","volume":"21","author":[{"given":"Ruoxi","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ling","family":"Lan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuguang","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,6,16]]},"reference":[{"issue":"6","key":"1388_CR1","doi-asserted-by":"publisher","first-page":"2587","DOI":"10.1542\/peds.2006-2780","volume":"118","author":"CJ Cote","year":"2006","unstructured":"American Academy of P, American Academy of Pediatric D, Cote CJ, Wilson S, Work Group on S. 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Before data collection, the study was approved by the Medical Ethics Committee of Peking Union Medical College Hospital and the registration number was S-K1301. A waiver of consent was approved by the institutional review board of Medical Ethics Committee of Peking Union Medical College Hospital because it was a retrospective analysis.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors state no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"171"}}