Nitrous oxide Analgesia – Conscious sedation
Conscious Sedation is a method used in dentistry to obtain satisfactory results in clients pain management. Delivery of Nitrous Oxide plus Oxygen under close monitoring of the Dentist, releases an analgesic effect in the body making the dental appointment less stressful and pain more tolerable by the client
The definition:
Conscious sedation is a controlled, pharmacologically induced process. It is characterized by a minimal level of consciousness which retains patient’s ability to maintain a patent airway independently and respond appropriately to physical stimulation. Sedation & General anesthesia are a part of the pharmacological techniques for management of children and adults.
What is nitrous oxide?
Itss the only agent used with inhalation technique that meet the requirement of sedation is nitrous oxide
Properties of nitrous oxide:
- Sweet smelling, colourless, inert gas
- Heavier than air.
- Nonflammable but supports combustion.
- Always coupled with more then 40% O2.
- Rapidly absorbed from lung alveoli with rapid excretion when concentration gradient is reversed.
Nitrous oxide rapidly enters the alveoli and as a result, the oxygen present become diluted. this is due to the fact that nitrous oxide is 34 times more soluble than nitrogen.
To overcome this problem :
Nitrous oxide concentration during maintenance phase should be kept as low as possible. (Usually 30%). It is recommended that the patient be maintained on 100% O2 for 5-10 minutes after the procedure.
Equipment used for delivering nitrous oxide-oxygen
The machine is of continuous flow design type with flow meters capable of accurate regulation. A fail-safe mechanism that provides automatic shutdown if oxygen falls below 20% with audible and visual alarms is an important design feature. There should be a flush-lever for easy immediate flushing of the system with 100% oxygen
