4:55 pm Martin Bastuba

Nitrous oxide is a colorless gas with a faintly sweet or metallic taste and odor. It is commonly known as laughing gas or nitrous. It is most well known for its use in dental offices and has been used in the clinical dentistry setting for over 150 years. Nitrous oxide can also be found in doctor’s offices who perform minor, out-patient procedures and is also sometimes used by women in labor.

Why should you use it?

Nitrous oxide has gained popularity due to its mild sedative, analgesic (pain relieving) and anxiolytic (anti-anxiety) properties. Minimizing anxiety or tension in a minor surgery where the patient is awake is incredibly helpful not just for the patient’s well being but because a tense patient may experience more post-operative pain due to that tension. Nitrous oxide also greatly decreases pain with the application of a local anesthetic (no needle is used, but some may still tense up in apprehension), so there really is no need to worry about any aspect of the procedure.

How safe is it?

While inhaling large amounts of nitrous oxide can be hazardous, the delivery system that SDVC employs allows for precise dosage and a maximum of 50% of each nitrous oxide and oxygen. SDVC’s machine is equipped with a disposable, sterile mouthpiece that only releases the gas as the patient seals his mouth around the mouthpiece and inhales. This allows the patient to have full control of the amount of nitrous oxide consumed and is also much safer for the staff by preventing a surplus of atmospheric nitrous oxide in the procedure room.

What does it feel like?

The most common sensations experienced after the intake of nitrous oxide are euphoria, excitement, a feeling of floating, and happiness. In severe cases, dizziness, nausea, light-headedness, and unsteadiness can also occur. If the patient feels discomfort due to the intake of nitrous oxide, he or she can simply abstain from further intake of nitrous oxide.

How does it work?

When nitrous oxide is inhaled, it is absorbed into the bloodstream via the lungs and is then discarded via exhalation. Nitrous oxide has a half-life of five minutes. Therefore, the patient will be able to drive himself home after around 10 minutes or so. The method of action that allows it to generate these effects is still not entirely understood. It is theorized that nitrous oxide acts similar to an opioid in the body, thus the analgesic effect and acts similar to benzodiazepines, thus the anxiolytic effect. 

Who should not use it?

Though nitrous oxide is considered a very mild anesthetic, it is not suited for a small population. Individuals with contraindications for the use of nitrous oxide include those who are/have: 

  • Pregnant
  • Vitamin B-12 deficient
  • Hypersensitive to nitrous oxide mixtures
  • Artificial, traumatic or spontaneous pneumothorax
  • Air embolism
  • Middle ear occlusion, ear infection
  • Eye surgery with intra-ocular gas injection within the last 6 weeks
  • Decompression sickness
  • Severe abdominal distension secondary to intra-abdominal air / intestinal obstruction
  • Inability to follow directions
  • Inability to hold the mouthpiece (delivery device)

Please feel free to contact Dr. Bastuba’s office if you have any questions or would like to schedule an appointment at 619-286-3520.

 1Lin MJ, Dubin DP, Khorasani H. Nitrous Oxide Reduces Pain Associated With Local Anesthetic Injections. J Cutan Med Surg. 2019 Nov/Dec;23(6):602-607. doi: 10.1177/1203475419867606. Epub 2019 Aug 12. PMID: 31402695.

2Alai, A. N., MD. (2019, November 09). Nitrous oxide Administration. Retrieved March 16, 2021, from https://emedicine.medscape.com/article/1413427-overview#:~:text=Nitrous%20oxide%20is%20administered%20by,is%20actually%20metabolized%20in%20humans

3Emmanouil, Dimitris E, and Raymond M Quock. “Advances in understanding the actions of nitrous oxide.” Anesthesia progress vol. 54,1 (2007): 9-18. doi:10.2344/0003-3006(2007)54[9:AIUTAO]2.0.CO;2