Nitrous Oxide - A Rentry by ❆
Introduction
Nitrous oxide is an odorless, colorless, non-flammable gas. While nitrous oxide is not flammable, it will support combustion to the same extent as oxygen. It leads to a state of euphoria, explaining its nickname, 'laughing gas.' Nitrous oxide is the least potent inhalational anesthetic. Compared to other anesthetic agents, nitrous oxide causes minimal effects on respiration and hemodynamics. It cannot be a sole anesthetic agent and is often combined with a more potent and volatile anesthetic. The combination of analgesic and anesthetic effects makes nitrous oxide a valuable adjunct. This activity outlines the indications, mechanism of action, methods of administration, significant adverse effects, contraindications, monitoring, and toxicity of nitrous oxide, so providers can direct patient therapy to optimal outcomes in anesthesia and other conditions where nitrous oxide has therapeutic benefits.
Nitrous oxide requires a concentration of 104% to reach one minimum alveolar concentration (MAC). Thus it cannot be a sole anesthetic agent, and it is often combined with a more potent and volatile anesthetic. The combination of analgesic and anesthetic effects makes nitrous oxide a valuable adjunct. Nitrous oxide has a low blood solubility (blood-gas partition coefficient of 0.47), leading to a quick onset and offset. The low solubility leads to a concentrating effect for administered volatile agents in the lungs and is known as the second gas effect.
Nitrous oxide is also being investigated as a potential agent for treatment-resistant depression. However, further extensive research is needed.
References
Zafirova Z, Sheehan C, Hosseinian L. Update on nitrous oxide and its use in anesthesia practice. Best Pract Res Clin Anaesthesiol. 2018 Jun;32(2):113-123.