Formulary
Nitrous oxide: Indications, Dosing, Side Effects and Interactions
Nitrous oxide clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Nitrous oxide: Indications, Dosing, Side Effects and Interactions
Nitrous oxide clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Maintenance of anaesthesia in conjunction with other anaesthetic agents**
- **Adult** (By Inhalation): 50-66 %, to be administered using suitable anaesthetic apparatus in oxygen.
**Analgesia**
- **Adult** (By Inhalation): Up to 50 %, to be administered using suitable anaesthetic apparatus in oxygen, adjusted according to the patient's needs.
**Maintenance of anaesthesia in conjunction with other anaesthetic agents for nitrous oxide**
- **Neonate** (By inhalation): 50-66 %, to be administered using suitable anaesthetic apparatus in oxygen.
- **Child** (By inhalation): 50-66 %, to be administered using suitable anaesthetic apparatus in oxygen.
**Analgesia for nitrous oxide**
- **Neonate** (By inhalation): Up to 50 %, to be administered using suitable anaesthetic apparatus in oxygen, adjusted according to the patient's needs.
- **Child** (By inhalation): Up to 50 %, to be administered using suitable anaesthetic apparatus in oxygen, adjusted according to the patient's needs.
Cautions
Entrapped air following recent underwater dive; pneumothorax; presence of intracranial air after head injury; recent intra-ocular gas injection Cautions, further information Nitrous oxide may have a deleterious effect if used in patients with an air-containing closed space since nitrous oxide diffuses into such a space with a resulting increase in pressure. This effect may be dangerous in conditions such as pneumothorax, which may enlarge to compromise respiration, or in the presence of intracranial air after head injury, entrapped air following recent underwater dive, or recent intra-ocular gas injection.
Side effects
Frequency not known Abdominal distension; addiction; agranulocytosis; disorientation; dizziness; euphoric mood; megaloblastic anaemia; middle ear damage; myeloneuropathy; nausea; paraesthesia; sedation; subacute combined cord degeneration; tympanic membrane perforation; vomiting Side-effects, further information Exposure of patients to nitrous oxide for prolonged periods, either by continuous or by intermittent administration, may result in megaloblastic anaemia owing to interference with the action of vitamin B 12 ; neurological toxic effects can occur without preceding overt haematological changes. Depression of white cell formation may also occur.
Pregnancy
May depress neonatal respiration if used during delivery.
Breast feeding
Breast-feeding can be resumed as soon as mother has recovered sufficiently from anaesthesia.
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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