Nitrous Oxide, From the Operating Room to the Emergency Department

  title={Nitrous Oxide, From the Operating Room to the Emergency Department},
  author={Christine Huang and Nathaniel R. Johnson},
  journal={Current Emergency and Hospital Medicine Reports},
  pages={11 - 18}
Nitrous oxide is a gas inhalation agent that has a long history of administration in procedures requiring analgesia and sedation. Although use may be limited by patient condition, patient comorbidities, and appropriate scavenging equipment, nitrous is a proven and safe tool for use in many health care settings—from the dental office to the operating room to the emergency department. 
The Benefits of Introducing the Use of Nitrous Oxide in the Pediatric Emergency Department for Painful Procedures
Professional negligence during nitrous oxide sedation and child fatality in dental office and suggested precautions: A short communication on childcare and nitrous oxide sedation
This article reviewed more than thirty studies with data focussing on death associated with dental anaesthesia using nitrous oxide (N2O) and given the list of guidelines and dietary care for children during N2O anaesthetic procedures inside the dental office.
Complications caused by nitrous oxide in dental sedation
  • S. Chi
  • Medicine
    Journal of dental anesthesia and pain medicine
  • 2018
The first clinical application of nitrous oxide (N2O) was in 1844, by an American dentist named Horace Wells who used it to control pain during tooth extraction. Since then, N2O has shared a 170-year
Nitrous Oxide Utility in Labor and Birth: A Multipurpose Modality
  • M. Collins
  • Medicine
    The Journal of perinatal & neonatal nursing
  • 2017
A comparison of obstetrical use to use in the dental industry, examines the contraindications to, and implications for usage, and discusses logistical points of consideration for clinicians working with women using N2O for labor and birth are explored.
Trauma pain management in the emergency department: use of methoxyflurane as a patient-administered analgesic.
  • C. Wood
  • Medicine
    Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association
  • 2022
A service development project introduced the use of a patient-administered analgesic, methoxyflurane, for patients with traumatic injuries with moderate to severe pain in one ED, and describes the main elements of training sessions for emergency nurses and other ED clinicians in the administration and supervision of patient- Administered methoxyFLurane.
Challenges in procedural sedation and analgesia in the emergency department
The assessment and monitoring necessary for PSA administration, the most commonly available and used pharmaceutical agents and the required knowledge, skills, and interventions that are necessary to manage potential complications related to PSA in the ED setting are discussed.
Impact of Opioid Analgesia and Inhalation Sedation Kalinox on Pain and Radial Artery Spasm during Transradial Coronary Angiography
Investigation of the respective impact of opioids analgesia and inhalation sedation with a 50% nitrous oxide/oxygen premix (Kalinox) on pain and occurrence of RAS during transradial coronary procedures found procedural inhalation Sedation by Kalinox is as safe as opioids analgesIA during trans Radial coronary angiography.
Utility and safety of low-concentration nitrous oxide anesthesia in ptosis surgery
P Ptosis surgery with anesthesia using 30% N2O may effectively suppress intraoperative BP and HR along with pain and shorten the operation time without side effects such as nausea.


Seizures Temporally Associated With Nitrous Oxide Administration for Pediatric Procedural Sedation
3 cases of clinical seizure activity associated with nitrous oxide administration for pediatric procedural sedation are reported, although temporally related, no causality is established.
The scavenger device for nitrous oxide administration.
Effectiveness of fixed 50% nitrous oxide oxygen mixture and EMLA cream for insertion of central venous catheters in children
To assess the safety and the effectiveness of this gas mixture for insertion of central venous catheters, a prospective observational study was conducted.
High-Concentration Nitrous Oxide for Procedural Sedation in Children: Adverse Events and Depth of Sedation
In this largest prospective emergency department series, high-concentration continuous-flow nitrous oxide (70%) was found to be a safe agent for procedural sedation and analgesia when embedded in a comprehensive sedation program.
Applications of Nitrous Oxide for Procedural Sedation in the Pediatric Population
  • J. Tobias
  • Medicine
    Pediatric emergency care
  • 2013
In general, N2O is a useful adjunct for procedural sedation and has been shown to be effective for a variety of minor surgical procedures such as venipuncture, intravenous cannula placement, lumbar puncture, bone marrow aspiration, laceration repair, dental care, and minor dermatologic procedures.
Effect of nitrous oxide analgesia on pneumothorax.
Although PNTX size increases with 50% N2O use, the magnitude observed in this animal model is less than previously reported.
Use of a combined oxygen/nitrous oxide/morphine chlorydrate protocol for analgesia in burned children requiring painful local care
This study demonstrates that the use of a simple protocol of inhalational oxygen/nitrous oxide mixtures associated with oral opioids could be safe and effective and was well tolerated without any adverse effect.
Is nitrous oxide necessary in the future?
This paper reflects a summary of a pro–con debate on the current and future use of nitrous oxide in pediatric anesthesia practice, held at the International Assembly for Pediatric Anesthesia, in
Nitrous oxide for early analgesia in the emergency setting: a randomized, double-blind multicenter prehospital trial.
  • J. Ducassé, G. Siksik, V. Bounes
  • Medicine
    Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
  • 2013
This study demonstrates the efficacy of N(2) O for the treatment of pain from acute trauma in adults in the prehospital setting in patients with out-of-hospital moderate traumatic acute pain.