Nitrous oxide (chemical compound N2O) is a non-flammable, colourless gas with a slightly sweet odour. It is a dissociative drug which was discovered in 1772 and has been in common usage recreationally since the early 1800s.
The psychological effects of nitrous oxide were discovered in 1799 by British chemist and inventor Humphry Davy. When inhaled, nitrous oxide can cause euphoria, sedation, analgesia (pain relief), laughter/giggling, dissociation of the mind from the body, auditive distortions, visual hallucinations (rare) and other phenomena. In 1800, Humphrey Davy started marketing nitrous oxide as a recreational drug. Nitrous oxide was called ‘laughing gas’ and its use became popular at social events, predominantly those of the British upper classes, where it was commonly sold for entertainment. In modern times, nitrous oxide is sometimes used at parties, usually filled into balloons and inhaled from them.
As it's primary medical use is sedative and analgesic, nitrous oxide is used as an anaesthetic in dentistry and sometimes in surgery. Nitrous oxide is also used in the dairy industry, in car racing, in welding and in rocket engines.
Advantages of Nitrous Oxide :-
- Nitrous oxide works very rapidly – it reaches the brain within 20 seconds, and relaxation and pain-killing properties develop after 2 or 3 minutes.
- The depth of sedation can be altered from moment to moment, allowing the person who administers the gas to increase or decrease the depth of sedation. Other sedation techniques don't allow for this. For example, with IV sedation, it's easy to deepen the level of sedation, but difficult to lessen it. Whereas with laughing gas, the effects are almost instant.
- 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. It can also be switched off when not needed and then switched on again (though to avoid a roller-coaster effect, you shouldn't do this too abruptly).
- 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.
- With nitrous oxide, it's easy to give incremental doses until the desired action is obtained (this is called "titration"). So the administrator has virtually absolute control over the action of the drug, preventing the possibility of accidental overdoses. While giving incremental doses is possible with IV sedation, it's not possible with oral sedation (as a result, oral sedation can be a bit of a hit-and-miss affair).
- For certain procedures – those involving gums rather than teeth (e. g. deep cleaning) – it may be possible to use nitrous instead of local anaesthesia. N2O acts as a painkiller on soft tissues such as gums. However, its pain-relieving effects vary a lot from person to person and can't be relied upon.
- No injection is required. In cases of very severe needle phobia, getting laughing gas first can help you feel relaxed enough to allow the needle required for IV sedation to be inserted in your arm or hand. The very deep state of sedation achievable through IV sedation will then allow you to accept local anaesthetic.
- 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.
Disadvantages :-
- Some people are not comfortable with the effects of laughing gas (either because they're afraid they might lose control or because it makes them feel nauseous – this is quite rare, though, and usually due to oversedation). If you're prone to nausea, it's a good idea to have a meal (not a huge one) about 4 hours before your appointment. If that's not possible (e. g. an early morning appointment), make sure your stomach isn't completely empty – but don't stuff yourself straight beforehand either.
- Some people will not achieve adequate sedation with permissible levels of oxygen.
- f you can't breathe through your nose (either because you're a pure mouth breather, or because your nose is blocked), or you feel too claustrophobic when something is put over your nose, it can't be used.
- Depending on where you live, a dentist who offers nitrous oxide may be hard to come by.
- Apart from that, most of the disadvantages of inhalation sedation don't affect you, but the dental team: there's training required, the equipment is quite bulky and takes up a lot of space, and there is a possibility that dental staff who are chronically exposed to nitrous oxide might develop health problems. The cost of the equipment and gases is high, so you'll have to contribute to the cost – but it's quite a bit cheaper than IV sedation.
Purity Specifications :-
| Purity | 98.0% V / V (Min) |
| Carbon Monoxide | 10 ppm V / V (Max) |
| Carbon Dioxide | 300 ppm V / V (Max) |
| Acidity / Alkalinity | Passes Limit Test |
| Arsine & Phosphine | Nil |
| Halogens & Hydrogen Sulphide | Nil |
| Nitric Oxide & Nitrogen Dioxide (NO / NO2) | 2 ppm V / V (Max) |
| Oxidising Substances | Nil |
| Moisture | 2.0 mg / litre (Max) |