Inhalation sedation, laughing gas, relative analgesia, RA, happy gas, gas and air, nitrous, nitrous oxide, N2O-O2… this one has more names than any other sedation technique! Inhalation sedation with nitrous oxide (N2O) and oxygen (O2) has been described as “representing the most nearly ‘ideal’ clinical sedative circumstance”…
Depending on the concentration and length of administration of laughing gas, four levels of sedation can be experienced (after an initial feeling of light-headedness):
- a tingling sensation, especially in the arms and legs, or a feeling of vibration (“parasthesia”), quickly followed by
- warm sensations, and
- a feeling of well-being, euphoria and/or floating. During heavier sedation, hearing may dissolve into a constant, electronic-like throbbing.
- At a deeper level of sedation again, sleepiness, difficulty to keep one’s eyes open or speak (“dream”) can occur. Should nausea set in, it means you’re definitely oversedated!
If you experience any unpleasant symptoms, let your dentist know so that they can adjust the percentage of N2O. Ideally, you have to be in the stage 3 of sedation. People that go to stage 4 usually have unpleasant experience with Nitrous Oxide. Nitrous Oxide concentration can vary from day to day. It’s best to start the titration slowly and increased gradually.
Interestingly, the mechanism of Nitrous Oxide is quite unknown. However, it has been observed that Nitrous Oxide depresses almost all forms of sensations, including hearing, touch and pain. The ability to concentrate and perform intelligent acts in only minimally affected, as in memory.
Nitrous oxide is administered through a nose hood. Flowmeters and pressure gauges allow the administrator to keep an eye on the flow of gases. All you need to do is breath normally through the nose hood.
ADVANTAGES of Nitrous Oxide:
- Nitrous oxide works very rapidly within 2 or 3 minutes. Hence, the effect is instant.
- Unlike other sedation techniques, the depth of sedation can be altered from moment to moment.
- Sedation duration is completely under control. If you feel uneasy, Nitrous Oxide can be flushed instantly. Other sedation techniques have a fixed duration of action (because the effects of pills or intravenous drugs last for a specific time span), whereas gas can be given for the exact time span it’s needed for
- There’s no “hangover” effect – the gas is eliminated from the body within 3 to 5 minutes after the gas supply is stopped. You can safely drive home and don’t need an escort.
- Needles can be avoided in certain procedures, those involving gums rather than teeth (e. g. deep cleaning) – it may be possible to use only nitrous oxide. However, its pain-relieving effects vary a lot from person to person and can’t be relied upon.
- Inhalation sedation is very safe. It has very few side effects and the drugs used have no ill effects on the heart, lungs, liver, kidneys, or brain.
- Inhalation sedation has been found to be very effective in eliminating or at least minimizing severe gagging.
- Safe on people that suffer from epilepsy, liver disease, heart problems, diabetes or cerebro-vascular disease.
- Lot cheaper than GA session or IV sedation.
- Some people are not comfortable with the effects of laughing gas.
- Can cause nausea in some people.
- Some people will not achieve adequate sedation with permissible levels of oxygen.
- Cannot be used in people with a blocked nose.
- People with Haemoglobin disorders/ COPD/ Lung disorders will need medical review before administrating Nitrous Oxide. Use of Nitrous Oxide in first trimester of pregnancy in unknown.
Is Nitrous Oxide for you?
Talk to us about Nitrous Oxide sedation on your next visit and feel free to ask for a 5 minutes ‘SAMPLE’ sedation session to know what to expect on the day of your procedure!