Nitrous oxide hazards and pharmacologic effects

Nitrous oxide hazards and pharmacologic effects

Hazards for the Patient

1.      If enclosed space-contraindicated such as pneumothorax.

2.      Upper Respiratory tract infection.

3.      Respective depression where respiration is on CO2 drive, as O2 increase will diminish this drive e.g. bleomycin therapy-pulmonary fibrosis.

4.      Pregnancy as spontaneous abortions may occur. ( in general most of the health professionals consider NO2 the safest method of sedation).

5.       Diffusion hypoxia, which can be avoided by keeping the patient on 100% oxygen.

Patient/personnel

DNA synthesis affected- Vitamin B12 oxidation may be suppressed even with brief exposure of at least 6 hours, altered hematopoesis, pernicious anemia.

Pharmacology of NO2

The patient at rest has tidal volume of 6-8 litres. with anxiety this increases. Thus it is necessary to establish flow rate as per the patients tidal volume.

Nitrous oxide is carried in a simple solution in the body and does not enter any chemical combination i.e. its solubility in blood is extremely low. thus free state is high and a rapid equilibrium between alveolar and arterial tension takes place & the onset as well as elimination occurs in a few minutes.

It is a weak GA gas and cannot produce full general anaesthesia on its own. but it is an excellent analgesic.

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