Application of nitrous oxide | Laughing gas

Application of nitrous oxide

The application is done as follows: the patient is held in front of the face with a mask containing laughing gas and is asked to inhale normally. The mask is then placed directly on the nose. The effect sets in within a few seconds and puts the patient into a deep sleep.

A further advantage of laughing gas is its gaseous availability. In an emergency it is not absolutely necessary to use a venous access (but recommended for safety reasons). During birth, the use of nitrous oxide is not so widespread, but is sometimes used.

Here, however, nitrous oxide is used less for sedation than for pain relief of the contractions. Since 2008, a nitrous oxide/oxygen mixture has been approved in Germany for use as a painkiller during childbirth. In countries such as Scandinavia or England, this preparation has been on the market for a long time.

A gas mixture of 50% nitrous oxide with 50% oxygen is necessary for the sole pain relief during birth. It is important that the gas mixture is already inhaled before each contraction in order to dampen a corresponding pain attack. Laughing gas mixtures are used in obstetrics above all when there are objections and contraindications for other pain procedures.

Today, however, epidural anaesthesia (PDA) has become the preferred method of pain management in obstetrics. If a less invasive pain treatment is desired, the mother can also be given painkillers in the form of an infusion. Here, drugs such as pethitine (Dolantin®) are used.

Laughing gas is probably the most frequently used drug in dentistry today.Especially in pediatric dentistry, nitrous oxide is very popular and is often used. While in adults a local anaesthetic is often injected into the gum area, a different method of anaesthesia must be found for children. Laughing gas has the decisive advantage that it can be administered directly to the patient through a nebulizer and a mask.

During dental procedures, e.g. when filling teeth or pulling teeth, it is often sufficient to hold a nitrous oxide and oxygen mixture in front of the child’s nose. The child inhales the gas and becomes calmer on the one hand and the pain sensation is reduced on the other. In dentistry, deep sleep anesthesia is often not necessary at all.

After the procedure the gas is turned off and the little patient can be discharged immediately without further observation. Shortly after the gas is turned off, however, nausea, slight dizziness and headaches may still occur. These side effects are relatively rare and usually last only a few hours.

For safety reasons, however, it is regulated in Germany in such a way that dental practices that perform procedures under nitrous oxide must have an anesthesiologist in the practice. These anaesthetists are often freelance and not employed by a hospital and travel from dental practice to dental practice.