Nitrous Oxide*

• Nitrous Oxide 

• Nitronox; Entonox

Classification:

• Analgesic gas

Mechanism of Action:

• Blended mixture of 50% O2 and 50% N2O that has potent analgesic effects
• CNS depressant with analgesic properties
• Effects last only 2 - 5 minutes after administration ceases

Indications:

• Acute pain associated with MSK injury, ACS, Renal colic, perinatal, burns and ABD pain
• Temporary relief of mild to moderate pain from painful procedures (splinting, etc)
• Acute anxiety

Contraindications:

• Patients that cannot comprehend verbal instructions or who are intoxicated
• Gas trapping conditions
  • Possible bowel obstruction
  • Air embolism
  • Pneumothorax
  • Middle ear infection
  • Decompression sickness
• COPD or signs of respiratory distress including SaO2 < 90%
• Head injury
• Altered mental status

Precautions:

• Use in well-ventilated area (Inhalation by provider possible)
• Anytime > 50 % oxygen is required
• Gases may separate at -6 degrees Celsius
  

Adverse Effects:

• Dizziness
• Light headiness
• Altered mental status
• Hallucinations
• Apnea
• N/V

Dose:

• Self-administered

• Inhaled

• Compendium of Pharmaceuticals and Specialties (CPS)
• Pharmacology for the Prehospital Provider 2nd Edition