What is the role of inhaled nitrous oxide in emergency department (ED) sedation?

Updated: Nov 06, 2018
  • Author: Arul M Lingappan, MD; Chief Editor: Erik D Schraga, MD  more...
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The inhaled anesthetic nitrous oxide, as a 30-70% mixture in oxygen, acts as a sedative and analgesic. It has a rapid onset of action (1-2 min) and a rapid duration of action (5 min). It is thought to act by binding to the opiate receptors in the CNS. Adverse effects include vomiting and hypoxia, if not mixed with an adequate oxygen percentage fraction.

The sedative properties of nitrous oxide are more noticeable clinically than its analgesic properties. Therefore, unless the procedure is a minor one, coadministration with an analgesic is recommended. [22] A scavenging system is often required for its use to prevent environmental air contamination. While some data suggest some utility, particularly in the pediatric population, [23] nitrous oxide is not routinely administered in the ED. For more information, see Nitrous Oxide Administration.

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