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