Inhalation sedation with nitrous oxide is an easy and hassle-free form of sedation of patients, both adults and children, who cannot cope with stress in the dental chair. This gas has relaxing and calming properties, accompanied by a marginal soporific effect. It does not excessively relax muscles or dull the patient, but allows one to maintain full contact with him/her. Gas ceases to work very quickly after its administration stops; therefore, it is possible for the patient to get behind the wheel of a car after the surgery.
The advantages of using nitrous oxide (the so-called laughing gas) comprise, most of all, pain relief, anxiety relief, in rare cases – hallucinogenic effect and retrograde amnesia. The analgesic effect is not too strong, but it offers some possibility to reduce sensation during certain surgery types with low-severity of pain, for example, initial caries removal, removal of calculus, local and regional anaesthesia, removal of stitches, and so on.
Sedation helps reduce discomfort in patients with a strong gag reflex, for example, during impression taking. Used in children it allows one to perform necessary procedures, which cannot be otherwise carried out effectively without general anaesthesia, due to the lack of cooperation between the child and the doctor. Often times children who required sedation do not need it any more after several surgeries. In older children and in adults sedation is recommended when patients become highly stressed whilst receiving injections when administering local anaesthesia.
The MASTER FLUX device is used to administer nitrous oxide. It is the most cutting-edge and advanced model of sedation devices.
Sedation with the mixture of N2O/O2 is particularly recommended for patients with:
- bronchial asthma, epilepsy, heart disease (the mixture containing nitrous oxide has no adverse effect on the heart ), hypertension (sedation reduces stress and unexpected pressure spikes associated with it), haemophilia (no need for needle insertion to administer anaesthetic)
The procedure is safe as it does not cause cardiac arrhythmias and may be administered to patients with heart conditions. It does not cause excessive muscle relaxation; therefore, it does not disturb the action of respiratory muscles. It has no effect on peripheral vessels, and thus it does not affect the blood pressure. Moreover, it does not affect significantly the respiratory centre, which means patients do not experience slowdown of breath and hypoxia. It does not irritate the mucous membrane of the tracheobronchial tree, which means it can be used in the case of patients with asthma. It only slightly reduces myocardial contractility. It does not accumulate in fat tissue which means it is promptly removed through lungs, making it very easy to control. Furthermore, extending administration to several hours does not affect recovery time, which invariably amounts to 30 min.
N2O/O2 should not be administered to patients:
- suffering from catarrh,
- suffering from acute sinusitis and acute otitis media,
- having a cochlear implant,
- women in the first trimester of pregnancy,
- suffering from porphyria,
- suffering from myasthenia gravis,
- suffering from bronchiectasis,
- suffering from emphysema,
- suffering from mental illness,
However, application of inhalation sedation in these cases does not cause a risk to the patient’s life. No special preparations on the side of the patient are necessary except for abstaining from eating for 3 hours before surgery; neither are there any special post-surgery precautions.