nitrous oxide

Nitrous Oxide

Category:

General anesthetic

Description:

Inhalation anesthetic

Indications:

General anesthesia
Severe pain (non-FDA approved)

Contraindications:

Air-enclosing cavities (cysts or air embolism), acute GI obstruction, pneumothorax
Head trauma, increased intracranial pressure, intracranial mass

Precautions:

Pregnancy; animal studies reveal possible link to fetal death, growth retardation
Prolonged use; 100% oxygen should be given to decrease risk of developing diffusion hypoxia
Chronic ethanol use may increase nitrous oxide anesthetic requirements

Adverse Reactions (Side Effects):

anemia, delirium
hypoxia, leukopenia,
increased intracranial pressure, nausea, vomiting
respiratory depression, shivering

Dosage:

Solely for inhalation administration and should only be given by individuals trained in the administration of general anesthetics. Dosage must be individualized.

General anesthesia induction:
- Adult:
  - INH 70% nitrous oxide with 30% oxygen for induction, followed by 30%-70% for maintenance of anesthesia
- Child:
  - individual dose must be determined
Severe pain control during obstetric or other procedures not requiring loss of consciousness:
- Adults:
  - 20%-50% INH nitrous oxide delivered with oxygen

Source: Operational Medicine 2001, Health Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington, D.C., 20372-5300