Nitrous Oxide & Oxygen Sedation - nitrous and its interaction with the body
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This document discusses the interaction of nitrous oxide with the body during minimal sedation. It notes that nitrous oxide improves patient perfusion while decreasing anxiety and has minimal effects on the cardiovascular and respiratory systems when used properly. However, it can depress reflexes and there are various medical conditions that require consultation or make nitrous oxide contraindicated due to risks such as hypoxia, gas expansion, or interference with vitamin B12 absorption. These include chronic respiratory diseases, cystic fibrosis, recent eye surgery, pregnancy in the first trimester, and various infections.
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Nitrous Oxide & Oxygen Sedation - nitrous and its interaction with the body
- 1. NitrousOxide Interaction With The Body ** Minimal Sedation ** Chapter 9 Based on Handbook of Nitrous Oxide & Oxygen Sedation, 3rd edition Morris S. Clark Ann L. Brunick Nitrous Oxide & Oxygen Sedation
- 2. Nitrous Oxide Continuous use because it is a safe drug It IMPROVES the patient’s perfusion while decreasing anxiety
- 3. Cardiovascular System Nitrous does not negatively affect the CV system Subanesthetic levels have minimal effect Does NOT create adverse effects Relaxation may lower BP
- 4. Respiratory System With minimal sedation ventilation is not depressed Airway patency is mandatory May delay care for sinusitis, URI, chest cold Rare complication silent regurgitation due to unconscious state reflexes are dulled due to loss of autonomic control Titration technique prevents deep sedation
- 5. Respiratory System Hypoxic potential airway resistance, impaired function emphysema chronic bronchitis hypoxic drive COPD patients
- 6. Respiratory System Patients with chronic respiratory disease should have medical consult pneumothorax air in pleural cavity – space expands due to N2O complication will occur
- 7. Respiratory System Cystic Fibrosis may incur bullae due to expansion of gases nitrous is therefore contraindicated
- 8. CNS Nitrous can depress the CNS Pneumoencephalography because of air expansion nitrous is contraindicated
- 9. Hematopoietic System Megaloblastic bone marrow changes with chronic exposure Nitrous interferes with Vitamin B12 dependent methionine synthetase this is needed for RBC production
- 10. Hematopoietic System pernicious anemia & other Vitamin B12 deficiency diseases medical consult needed
- 12. Hepatic System Nitrous is not metabolized in the liver No contraindications
- 13. GI System Nitrous gas will expand in the GI Bowel obstruction postpone Nitrous
- 15. Reproductive System Nitrous crosses the placenta to the fetus Medical Consult Mandatory Contraindicated in 1st trimester
- 17. Cancer Bleomycin Sulfate increases pulmonary fibrosis Avoid or Postpone for patients on the Rx
- 18. Allergies Use Latex Free materials
- 19. Malignant Hyperthermia not a trigger for MH may be used for MH susceptible patients
- 20. Nutritional Disorders Patients with known Vitamin B12 deficiency Obtain medical consult prior to nitrous
- 21. Cognitive Disorders Must determine the ability of patient to understand the sedation procedure
- 22. Mind - Altering Conditions Nitrous causes a euphoria contraindicated for patients with mind altering conditions drug / alcohol abuse history psychotropic drugs patients with phobias
- 23. Middle Ear Disturbances postpone if patient has a middle ear infection / problem gas expands and may rupture tympanic membrane
- 24. Eye Surgery Recent ophthalmic surgery perfluoropropane sulfur hexafluoride Nitrous would be contraindicated due to expansion of gas
- 25. Nitrous is Contraindicated Sleep Rx Recent eye surgery Patients in shock or semiconscious Serious head and facial injuries Patients unwilling to consent to nitrous
- 26. Relative Contraindications Medical Consult / Delay Pregnancy Sinus Infection Ear infections Debilitating CV Disease Phobia Bronchitis Mental Illness Late Stage HIV COPD TB Bowel Obstruction Alcohol or Drug Abuse