mini quiz b (nitrous oxide-oxygen analgesia)

Nitrous Oxide- Oxygen Analgesia is a type of

Inhalation sedation

Nitrous Oxide - Oxygen Analgesia (N20 -02)

Increases pain threshold without loss of consciousness; analgesic, amnesic, anxiolytic

Nitrous Oxide-Oxygen Analgesia advantages:

a. rapid onset and recovery

b. least toxic, safe when used appropriately

c. may be used in children

a. nonflammable

e. nonirritating to the G.l tract

f. Good analgesia, anxiolytic (antianxiety) effect

Nitrous Oxide - Oxygen Analgesia disadvantages

Abuse potential

Reduction in fertility

Improper use of

Nausea

**Diffusion hypoxia

Abuse of nitrous oxide can lead to

numbness (paresthesia) of extremities

serious neurological problems (peripheral neuropathy)

liver/kidney problems

For Health care workers, being exposed to >5hr/week to nitrous oxide can increase the risk of miscarriage rates (T/F)

True

Most common concern pts have when using nitrous oxide:

Nausea

Nausea can occur due to

rapid changes in nitrous concentration; change levels slowly

diffusion hypoxia*

Most serious consequence of nitrous!

Comes from low 02 levels in blood

rarely occurs

Give 100% oxygen at the end of procedure to prevent.

**Scavenger System:

retrieves expired gases and increases room air turnover; reduces gas leakage

Nitrous oxide tank is

Blue

Oxygen tank is

Green

Nitrous Oxide-Oxygen Technique

• With pt. in supine position, start oxygen at 5-6 liters (100% oxygen)

  
  

• At 1 min. of 10% nitrous, suggest pt. may start feeling effects (oxygen stays the same)

• At 1 min of 20% nitrous, possible symptoms: warmth, relaxation (explain safety of

mouth breathing; if pt. feels dizzy/nauseous they can breathe through their mouth).

• 1 min of 25% nitrous (average pt. reaches appropriate sedation between 25%-45% nitrous oxide). Very few pts need 50% nitrous oxide. Maximum limit: 70%!

• Following sedation give 100% oxygen for at least 5 minutes to flush nitrous oxide from respiratory system. Allow pt. to recover sitting upright to avoid hypotension.

• Determine complete recovery before releasing pt. from office

Maximum limit of nitrous oxide:

75%

Nitrous Oxide-Oxygen Contraindications

• Respiratory Problems

1. Upper Respiratory Tract Infections

2. Chronic Obstructive Pulmonary Diseases

(COPD) emphysema, chronic bronchitis

(asthma is NOT a contraindication)

• Pregnancy

  
  

• Lack of communication

1. Mental/Emotional illness

2. Uncooperative kids/adults Autistic children/adults

3. foreign language

4. Blocked eustachian tubes

The combination of a CNS depressant with nitrous oxide-oxygen analgesia may lead to

Respiratory depression

Review medical history for

1. emotional/mental health issues

2. medications, esp. CNS depressant meds

Meds for depression, bipolar disease, anxiety, schizophrenia, psychosis