Nitrous oxide, no less than 98.0% (V / V), medical liquefied gas
Nitrous oxide, not less than 98.0% (V / V), medical liquefied gas, Messer Poland
indications:
Nitrous oxide is used to introduce and maintain general anesthesia in combination with other anesthetics (inhalation or intravenous). In a mixture with oxygen, it is used to achieve analgesic effect induced by shallow anesthesia without losing consciousness (perinatal analgesia).
Composition:
Liquefied medical gas, contains not less than 98% (V / V) of nitrous oxide.
Action:
Nitrous oxide produces a temporary elimination of pain sensitivity and suppression of vegetative reflexes, depending on the dose. Nitrous oxide with very high concentration (over 80% in the breathing mixture) leads to loss of consciousness. It does not eliminate any movements, but it has a negative inotropic effect. One should always take into account the possibility of hypoxia. Due to the small blood / gas distribution coefficient (0.468), the level of analgesia induced by nitrous oxide is easily controlled. The amount of nitrous oxide reaching individual tissues depends on their blood supply. N2It does not affect the metabolism. No reliable research on biotransformation. Nitrous oxide is mainly excreted unchanged by the lungs, small amounts are removed through the skin and intestines.
Contraindications:
Do not use nitrous oxide without added oxygen or in a breathing mixture containing less than 30% oxygen. The time of administration in a mixture with oxygen should not be longer than 24 hours. Do not use in case of hypersensitivity to N2ABOUT.
Precautions:
Use with caution in patients with severe lung function disorder (hypoxaemia), severe heart failure, increased intracranial pressure, hypovolaemia and shock. Nitrous oxide has the ability to penetrate body cavities filled with gases (eg, collateral sinusitis, middle ear, existing pneumothorax) resulting in increased volume or increased pressure. Nitrous oxide diffuses through elements made of plastics, eg during anesthesia with intubation it penetrates into the cuff of the endotracheal tube, which can lead to obstruction of the airways. If ventilation is carried out with air and not with pure oxygen, in the final phase of anesthesia, when nitrous oxide quickly penetrates from the blood into the alveolar space, diffusional hypoxia may occur. Exposure to low concentrations of nitrous oxide over a longer period (for medical personnel) can lead to bone marrow dysfunction (bone marrow aplasia). Threats can be mitigated by the assembly of anesthetic gases in the operating theaters.
Pregnancy and lactation:
There is no evidence of toxic effects on the human fetus. However, it is not recommended to use nitrous oxide in the first and second trimesters of pregnancy. Nitrous oxide passes through the placenta, the depth of the fetal anesthesia corresponds to the anesthesia of the mother. Animal studies have shown cases of fetal die-off, growth disturbance and bone development. No data or only limited data on the use of nitrous oxide in breast-feeding women. In order to be cautious, it is recommended to avoid the use of nitrous oxide in women during breastfeeding.
Side effects:
Although only a limited effect on the cardiovascular system should be expected, the cardiac output may decrease, the blood pressure decreases and the pulmonary vascular resistance may increase. Emotional states, dreams and fantasies have been described; the ability to move is limited. Administration of nitrous oxide causes a slight increase in intracranial pressure. Isolated cases have been reported in which the use of nitrous oxide induced malignant fever in patients. In addition to information on nausea and vomiting, there are reports of inhibitory effects on the bone marrow and neurological symptoms resulting from prolonged exposure to nitrous oxide (eg surgery lasting 6-10 h).
Dosage:
Nitrous oxide is used in inhalation. The dose and duration of use is determined by the medical personnel.In the case of introduction into general anesthesia, inhalation with a mixture of medical gases: 70% nitrous oxide and 30% oxygen should be carried out. During maintenance of general anesthesia, inhalation should be carried out with a mixture containing from 30% to 70% of nitrous oxide in oxygen. In obstetrics, where the preparation is used as an analgesic, the concentration of nitrous oxide ranges from 25% to 50% of the breathing mix (the remainder is oxygen). Limitations in the dosage method result from side effects caused by nitrous oxide and co-morbidities (severe heart failure, lung dysfunction, increased intracranial pressure). The absolute necessity of continuous monitoring of respiratory and circulatory functions by using ECG and pulse oximetry should be emphasized. Nitrous oxide should be administered using a face mask or an endotracheal tube.
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