Description of the medicine: Nitrous oxide (Nitrogenium oxydulatum)
NITROGEN ACID (Nitrogenium oxydulatum).
Synonyms: Dinitrogen ohide, Nitrous oxyde, Oxydum nitrosum, Rotohude d'Azote, Stickoxydal.
Colorless gas, heavier than air (relative density 1.527), characteristic odor. Soluble in water (1: 2). At 0 ° C and a pressure of 30 atm, as well as at ordinary temperature and a pressure of 40 atm, it thickens into a colorless liquid. From 1 kg of liquid nitrous oxide, 500 l of gas is formed. Not flammable, but supports combustion. Mixtures with ether, cyclopropane, chloroethyl in certain concentrations are explosive.
Low concentrations of nitrous oxide cause intoxication (hence the name "laughing gas>) and mild drowsiness. When inhaling pure gas, a narcotic state and asphyxia quickly develop. When mixed with oxygen, when dosed correctly, it causes anesthesia without prior excitement and side effects. Nitrous oxide has a weak narcotic activity, and therefore it must be used in high concentrations. In most cases, combined anesthesia is used, in which nitrous oxide is combined with other, more powerful, anesthetics and muscle relaxants.
Nitrous oxide does not cause respiratory irritation. In the body, it almost does not change, does not bind to hemoglobin; is in a dissolved state in plasma. After cessation of inhalation, it is released (completely in 10 - 15 minutes) through the respiratory tract unchanged.
Anesthesia using nitrous oxide is used in surgical practice, operative gynecology, surgical dentistry, and also for labor pain relief. <Medical analgesic anesthesia> (B.V. Petrovsky, S.N. Efuni) using a mixture of nitrous oxide and oxygen is sometimes used in the postoperative period for the prevention of traumatic shock, as well as for the relief of pain attacks in acute coronary insufficiency, myocardial infarction, acute pancreatitis and other pathological conditions, accompanied by pain that does not stop with conventional means.
Nitrous oxide is used in a mixture with oxygen using special apparatuses for gas anesthesia. Usually start with a mixture containing 70-80% nitrous oxide and 30-20% oxygen, then the amount of oxygen is increased to 40-50%. If it is not possible to obtain the necessary depth of anesthesia, at a concentration of nitrous oxide of 70 - 75%, more powerful drugs are added: fluorotan, ether, barbiturates.
For more complete relaxation of muscles, muscle relaxants are used, while not only muscle relaxation is enhanced, but the course of anesthesia is also improved.
After stopping the supply of nitrous oxide, oxygen should be continued for 4-5 minutes to avoid hypoxia.
Nitrous oxide should be used with caution in cases of severe hypoxia and impaired diffusion of gases in the lungs.
To anesthetize labor, they use the method of intermittent autoanalgesia using a mixture of nitrous oxide (40-75%) and oxygen using special anesthesia devices.