Yes

Dental Gases; General Anesthetic

Dental: To induce sedation and analgesia in anxious dental patients

Medical: A principal adjunct to inhalation and intravenous general anesthesia in medical patients undergoing surgery; prehospital relief of pain of differing etiologies (ie, burns, fractures, back injury, abrasions, lacerations)

No data reported

Nitrous oxide should not be administered without oxygen. Nitrous oxide should not be given to patients after a full meal

Nausea and vomiting occurs postoperatively in ~15% of patients. Prolonged use may produce bone marrow suppression and/or neurologic dysfunction. Oxygen should be briefly administered during emergence from prolonged anesthesia with nitrous oxide to prevent diffusion hypoxia. Patients with vitamin B₁₂ deficiency (pernicious anemia) and those with other nutritional deficiencies (alcoholics) are at increased risk of developing neurologic disease and bone marrow suppression with exposure to nitrous oxide. May be addictive

An increased risk of renal and hepatic diseases and peripheral neuropathy similar to that of vitamin B₁₂ deficiency have been reported in dental personnel who work in areas where nitrous oxide is used

Methionine synthase, a vitamin B₁₂ dependent enzyme, is inactivated following very prolonged administration of nitrous oxide, and the subsequent interference with DNA synthesis prevents production of both leukocytes and red blood cells by bone marrow. These effects do not occur within the time frame of clinical sedation.

Female dental personnel who were exposed to unscavenged nitrous oxide for more than 5 hours/week were significantly less fertile than women who were not exposed, or who were exposed to lower levels of scavenged or unscavenged nitrous oxide. Fertility was measured by the number of menstrual cycles, without use of contraception, required to become pregnant. Women who were exposed to nitrous oxide for more than 5 hours/week were only 41% as likely as unexposed women to conceive during each monthly cycle.

No data reported

General CNS depressant action; may act similarly as inhalant general anesthetics by mildly stabilizing axonal membranes to partially inhibit action potentials leading to sedation; may partially act on opiate receptor systems to cause mild analgesia

Nitrous oxide is rapidly absorbed via inhalation. The blood/gas partition coefficient is 0.5. The gas is rapidly eliminated via the lungs, with minimal amounts eliminated through the skin.

Children and Adults: For sedation and analgesia: Concentrations of 25% to 50% nitrous oxide with oxygen inhaled through the nose via a nasal mask

No data reported

No information available to require special precautions

No effects or complications reported

Supplied in blue cylinders

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"Nitrous Oxide in the Dental Office. ADA Council on Scientific Affairs; ADA Council on Dental Practice," J Am Dent Assoc, 1997, 128(3):364-5.

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Quarnstrom F, "Nitrous Oxide," J Am Dent Assoc, 1997, 128(6):690, 692.

Rowland AS, Baird DD, Weinberg CR, et al, "Reduced Fertility Among Women Employed as Female Dental Assistants Exposed to High Levels of Nitrous Oxide," N Engl J Med, 1992, 327(14):993-7.

Schuyt HC, Brakel K, Oostendorp SG, et al, "Abortions Among Dental Personnel Exposed to Nitrous Oxide," Anaesthesia, 1986, 41(1):82-3.

Wynn RL, "Nitrous Oxide and Fertility, Part I," Gen Dent, 1993, 41(2):122-3.

Wynn RL, "Nitrous Oxide and Fertility, Part II," Gen Dent, 1993, 41(3):212, 214.