Nitrous Oxide

Category:

  • General anesthetic

Description:

  • Inhalation anesthetic

Indications:

  • General anesthesia

  • Severe pain (non-FDA approved)

Contraindications:

  • Air-enclosing cavities (cysts or air embolism), acute GI obstruction, pneumothorax

  • Head trauma, increased intracranial pressure, intracranial mass

Precautions:

  • Pregnancy; animal studies reveal possible link to fetal death, growth retardation

  • Prolonged use; 100% oxygen should be given to decrease risk of developing diffusion hypoxia

  • Chronic ethanol use may increase nitrous oxide anesthetic requirements

Adverse Reactions (Side Effects):

  • anemia, delirium

  • hypoxia, leukopenia,

  • increased intracranial pressure, nausea, vomiting

  • respiratory depression, shivering

Dosage:

Solely for inhalation administration and should only be given by individuals trained in the administration of general anesthetics.  Dosage must be individualized.

  • General anesthesia induction: 

    • Adult: 

      • INH 70% nitrous oxide with 30% oxygen for induction, followed by 30%-70% for maintenance of anesthesia

    • Child: 

      • individual dose must be determined

  • Severe pain control during obstetric or other procedures not requiring loss of consciousness: 

    • Adults: 

      • 20%-50% INH nitrous oxide delivered with oxygen

Source: Operational Medicine 2001,  Health Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington, D.C., 20372-5300 


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