Kariman H, Majidi A, Taheri S Analgesic effects of inhalation of nitric oxide (Entonox) and parenteral morphine sulfate in patients with renal colic; a randomized clinical trial. Bull Emerg Trauma. 2015; 3:46-52
Emmanouil DE, Quock RM. Advances in understanding the actions of nitrous oxide. Anesth Prog. 2007; 54:9-18
Cohen EN, Gift HC, Brown BW Occupational disease in dentistry and chronic exposure to trace anesthetic gases. J Am Dent Assoc. 1980; 101:21-31 https://doi.org/10.14219/jada.archive.1980.0345
Consultant and Honorary Senior Lecturer in Special Care Dentistry; Clinical Lead, Department of Sedation and Special Care Dentistry, Guy’s and St Thomas’ NHS Foundation Trust, London
With increasing waiting lists across the UK for oral surgery under general anaesthesia (GA), inhalation sedation (IS) may provide the answer for patients to be treated more quickly. The authors believe it is an underused technique for the management of anxious and medically compromised patients requiring oral surgery. This article demonstrates, with patient examples, how IS can be used effectively.
CPD/Clinical Relevance: This article is relevant to general dental practitioners, oral surgeons and those working in sedation services.
Article
Many dentists associate inhalational sedation (IS) as a method of managing anxiety in children. While it is an excellent technique for younger people IS has applications for adults particularly those with medical complexities. This article highlights how the technique can be very effective for adult patients requiring oral surgery and can avoid the need for general anaesthesia for some.
With waiting lists at an all-time high and a shortage of anaesthetists, IS may provide the answer to long oral surgery waiting lists. The technique does require the operator to give psychological support and works best with an operator-sedationist. The equipment is bulky and requires either gases to be piped from centrally stored supplies or mobile E size cylinders. For mobile cylinders suitable gas storage is required. There are concerns about the effects of nitrous oxide (N2O) as a greenhouse gas and its contribution to climate change. The advantages for patients are obvious with its fast action, anxiolytic effects and fast recovery, which make it very suitable for mild to moderately anxious patients having oral surgery procedures. Although good local anaesthesia is required for any successful oral surgery, N2O has excellent analgesic properties and can be as effective as morphine.1
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