Nitrous oxide (Gas) Instructions for Use

ATC Code

N01AX13 (Nitrous oxide)

Active Substance

Nitrous oxide (BP British Pharmacopoeia)

Clinical-Pharmacological Group

Inhalation anesthesia preparation

Pharmacotherapeutic Group

Inhalation anesthetic agent

Pharmacological Action

An agent for inhalation anesthesia. When inhaled, it enters the lungs into the blood by diffusion. It causes anesthesia only at a concentration of 94-95% in the inhaled air, however, using such concentrations is impossible due to the threat of severe hypoxia.

In this regard, a mixture of nitrous oxide and oxygen is usually used in anesthesiology. When using the specified mixture, only the initial level of the stage of surgical anesthesia can be achieved, while sufficient muscle relaxation is absent.

In most cases, Nitrous oxide (in a mixture with oxygen) is used in combination with more potent anesthetic agents and muscle relaxants.

Pharmacokinetics

Nitrous oxide is poorly soluble in blood, quickly reaches high tension in arterial blood, which in turn leads to a faster (compared to other inhalation anesthetic agents) establishment of equilibrium concentrations in the brain and blood and accelerates the induction of anesthesia.

The blood/gas partition coefficient is low – 0.47, the brain/blood partition coefficient is 1.1, the minimum alveolar concentration is more than 100%. It is practically not metabolized in human tissues.

After cessation of inhalation, it is rapidly eliminated from the blood, completely excreted within 10-15 minutes through the respiratory tract unchanged, which causes a rapid recovery from anesthesia.

Indications

For inhalation anesthesia during surgical interventions, gynecological operations. For labor analgesia. Pathological conditions accompanied by pain that is not relieved by traditional means, including acute coronary insufficiency, myocardial infarction, acute pancreatitis.

ICD codes

Dosage Regimen

Gas

It is used in a mixture with oxygen using special gas anesthesia machines. Usually, they start with a mixture containing 70-80% nitrous oxide and 30-20% oxygen, then the amount of oxygen is increased to 40-50%.

If the required depth of anesthesia cannot be achieved at a nitrous oxide concentration of 70-75%, more potent anesthetic agents are added, including halothane, diethyl ether, barbiturates.

Adverse Reactions

From the hematopoietic system: with prolonged use, megaloblastic anemia, hemopoiesis disorders are possible.

From the peripheral nervous system: with prolonged use, peripheral neuropathy is possible.

Contraindications

As a therapeutic anesthesia in severe diseases of the nervous system, chronic alcoholism, state of alcohol intoxication (excitation, hallucinations are possible).

Use in Pregnancy and Lactation

It is used for labor analgesia.

If it is necessary to use during lactation, breastfeeding should be discontinued.

Pediatric Use

The dose is set individually.

Geriatric Use

The dose is set individually.

Special Precautions

Use with caution in severe hypoxia and impaired gas diffusion in the lungs.

Nitrous oxide does not cause irritation of the respiratory tract.

Drug Interactions

It is assumed that with simultaneous use of nitrous oxide and methotrexate, the adverse effect of the latter is enhanced. According to other data, Nitrous oxide enhances the therapeutic effect of methotrexate.

Storage Conditions

Store at 2°C (36°F) to 30°C (86°F). Keep in original packaging, protected from light. Keep out of reach of children.

Dispensing Status

Rx Only

Important Safety Information

This information is for educational purposes only and does not replace professional medical advice. Always consult your doctor before use. Dosage and side effects may vary. Use only as prescribed.