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Anesthesia Progress 2008Nitrous oxide is the most commonly used inhalation anesthetic in dentistry and is commonly used in emergency centers and ambulatory surgery centers as well. When used... (Review)
Review
Nitrous oxide is the most commonly used inhalation anesthetic in dentistry and is commonly used in emergency centers and ambulatory surgery centers as well. When used alone, it is incapable of producing general anesthesia reliably, but it may be combined with other inhalation and/or intravenous agents in deep sedative/general anesthetic techniques. However, as a single agent, it has impressive safety and is excellent for providing minimal and moderate sedation for apprehensive dental patients. To gain a full appreciation of the pharmacology, physiologic influences, and proper use of nitrous oxide, one must compare it with other inhalation anesthetics. The purpose of this CE article is to provide an overview of inhalation anesthetics in general and to address nitrous oxide more specifically in comparison.
Topics: Anesthesia, Dental; Anesthetics, Inhalation; Conscious Sedation; Contraindications; Humans; Nitrous Oxide
PubMed: 19108597
DOI: 10.2344/0003-3006-55.4.124 -
Anesthesiology Apr 2023
Topics: Nitrous Oxide; Postoperative Complications; Humans
PubMed: 36880788
DOI: 10.1097/ALN.0000000000004530 -
European Journal of Paediatric Dentistry Sep 2023Patient compliance is of paramount importance for proper dental treatment, which can be difficult to achieve in children due to anxiety and fear, hindering the...
AIM
Patient compliance is of paramount importance for proper dental treatment, which can be difficult to achieve in children due to anxiety and fear, hindering the therapeutic procedure. In addition to well-known sedation methods (pharmacological and nitrous oxide), further methods of approach are being tested, such as hypnotherapy.
MATERIALS
The sample consisted of 150 children (90 males, 60 females). Paper questionnaires, frequency meter, nitrous oxide dispenser in association with the use of the television were exploited. At the end of treatment, subjective pain was assessed using the VAS scale, while objective pain was assessed using the FLACC scale and heart rate. This made it possible to compare two experimental groups, one treated with nitrous oxide, and the other with hypnotherapy. The control group was treated with classic behavioural approach techniques. The results obtained were analysed by SPSS Software (Statistical Package for Social Science, version 27) and the inferences between the results were calculated for confirmation.
CONCLUSION
Hypnotherapy can be a valid substitute for nitrous oxide in paediatric dentistry.
Topics: Child; Female; Male; Humans; Pediatric Dentistry; Nitrous Oxide; Anxiety; Hypnosis; Pain
PubMed: 37668458
DOI: 10.23804/ejpd.2023.1932 -
Anesthesia Progress 2017Nitrous oxide and midazolam have been used as sedative agents to decrease fear and anxiety associated with dental procedures. Although these agents have been widely used... (Meta-Analysis)
Meta-Analysis Review
Nitrous oxide and midazolam have been used as sedative agents to decrease fear and anxiety associated with dental procedures. Although these agents have been widely used individually, the combination of the two is also commonly used. Four clinical trials were identified that compared the combination technique with the individual use of the drugs. The standardized mean difference (SMD) for each outcome measure was considered for final analysis. Three studies with 534 participants were included in the final meta-analysis, and the SMD [95% CI] was obtained as -0.15 [-0.32, 0.03] and was not statistically significant for cooperation scores. Two studies reported the dose of midazolam required for inducing sedation in 450 participants, and the pooled estimate of SMD [95% CI] was obtained as -0.29 [-0.48, -0.10] and was significant. Two studies with 450 participants reported the time taken to recover from sedation, and the pooled estimate of SMD [95% CI] was obtained as -0.20 [-0.39, -0.01] and favored the combination technique. To conclude, the combination technique combines the pros and cons of both drugs in causing fewer adverse effects due to midazolam by reducing the total dose and also helps to provide better acceptance of nitrous oxide inhalation.
Topics: Anesthesia, Dental; Conscious Sedation; Humans; Hypnotics and Sedatives; Midazolam; Nitrous Oxide; Outcome Assessment, Health Care
PubMed: 28604098
DOI: 10.2344/anpr-63-03-06 -
Australian Journal of General Practice Nov 2021Nitrous oxide is a colourless, odourless gas that has been used in medicine for more than 150 years for its anaesthetic and analgesic properties. Its first recorded use... (Review)
Review
BACKGROUND
Nitrous oxide is a colourless, odourless gas that has been used in medicine for more than 150 years for its anaesthetic and analgesic properties. Its first recorded use as a recreational drug was in early 19th century Britain at 'laughing gas parties', where it was used to provide short-lived euphoria to the bored upper class. A recent resurgence of its abuse among Australian youth has led to marked neurological morbidity.
OBJECTIVE
The aim of this article is to provide an overview of the clinical presentation, differential diagnosis, investigation and treatment of patients presenting with neurotoxicity due to recreational nitrous oxide abuse.
DISCUSSION
Nitrous oxide exerts its neurotoxicity through vitamin B12 inactivation, which disrupts myelin sheath maintenance, leading to peripheral and central nervous system demyelination. Importantly, patients often present with non-specific sensorimotor signs and symptoms with normal serum vitamin B12 levels. Early recognition and treatment are crucial to limit long-term neurological sequelae.
Topics: Adolescent; Australia; Humans; Nitrous Oxide; Vitamin B 12
PubMed: 34713284
DOI: 10.31128/AJGP-10-20-5668 -
Water Research Jun 2021The nitrous oxides emission was measured over 7 months in the full-scale aerobic granular sludge plant in Dinxperlo, the Netherlands. Nitrous oxide concentrations were...
The nitrous oxides emission was measured over 7 months in the full-scale aerobic granular sludge plant in Dinxperlo, the Netherlands. Nitrous oxide concentrations were measured in the bulk liquid and the off-gas of the Nereda® reactor. Combined with the batch wise operation of the reactor, this gave a high information density and a better insight into NO emission in general. The average emission factor was 0.33% based on the total nitrogen concentration in the influent. The yearly average emission factor was estimated to be between 0.25% and 0.30%. The average emission factor is comparable to continuous activated sludge plants, using flocculent sludge, and it is low compared to other sequencing batch systems. The variability in the emission factor increased when the reactor temperature was below 14 °C, showing higher emission factors during the winter period. A change in the process control in the winter period reduced the variability, reducing the emission factors to a level comparable to the summer period. Different process control might be necessary at high and low temperatures to obtain a consistently low nitrous oxide emission. Rainy weather conditions lowered the emission factor, also in the dry weather flow batches following the rainy weather batches. This was attributed to the first flush from the sewer at the start of rainy weather conditions, resulting in a temporarily increased sludge loading.
Topics: Bioreactors; Netherlands; Nitrogen; Nitrous Oxide; Sewage; Temperature; Waste Disposal, Fluid
PubMed: 33962240
DOI: 10.1016/j.watres.2021.117159 -
Lakartidningen Feb 2022
Topics: Air Pollutants, Occupational; Humans; Nitrous Oxide; Recurrence
PubMed: 35147206
DOI: No ID Found -
BioMed Research International 2019This Pro-Con debate will provide the practitioner with an evidence-based knowledge approach to assist the clinician in determining whether to employ (Pro) or not to... (Review)
Review
This Pro-Con debate will provide the practitioner with an evidence-based knowledge approach to assist the clinician in determining whether to employ (Pro) or not to employ (Con) this technique in the obstetrical suite for labor analgesia. Nitrous oxide has been used safely in dentistry and medicine for many centuries. However, accumulating preclinical and clinical evidence increasingly suggests previously unrecognized adverse maternal and fetal effects of nitrous oxide, which warrants reconsideration of its use in pregnant women and a more detailed informed consent. Nitrous oxide is associated with metabolic, oxidative, genotoxic, and transgenerational epigenetic effects in animals and humans that may warrant limiting its usefulness in labor. This debate will discuss and review the clinical uses, advantages, and disadvantages of nitrous oxide on occupational effects of nitrous oxide exposure, neuroapoptosis, FDA warning on inhalational anesthetics and the developing brain, research limitations, occupational exposure safety limits, effects on global warming, and potential for diversion.
Topics: Anesthetics, Inhalation; Animals; Female; Fetus; Humans; Labor, Obstetric; Nitrous Oxide; Pain Management; Pregnancy
PubMed: 31531352
DOI: 10.1155/2019/4618798 -
Lakartidningen Nov 2023
Topics: Humans; Nitrous Oxide
PubMed: 37933768
DOI: No ID Found -
Lakartidningen Nov 2023
Topics: Humans; Nitrous Oxide; Thrombosis
PubMed: 37933769
DOI: No ID Found