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Medication description: nitrous oxide (nitrogenium oxydulatum)

NITROGEN (Nitrogenium oxydulatum).

Synonyms: Dinitrogen ohide, Nitrous oxyde, Oxydum nitrosum, Protoxode d'Azote, Stickoxydal.

Colorless gas, heavier than air (relative density 1.527), characteristic odor. Soluble in water (1: 2). At 0 C and pressure of 30 atm, as well as at ordinary temperature and pressure of 40 atm, it condenses into a colorless liquid. 500 liters of gas is produced from 1 kg of liquid nitrous oxide. Does not ignite, but supports burning. Mixtures with ether, cyclopropane, chloroethyl in certain concentrations are explosive.

Low concentrations of nitrous oxide cause a feeling of intoxication (hence the name <laughing gas>) and slight drowsiness. Inhalation of pure gas quickly develops a narcotic state and asphyxia. In a mixture with oxygen with the right dosage causes anesthesia without prior excitation 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, means of anesthesia and muscle relaxants.

Nitrous oxide does not cause irritation of the respiratory tract. In the body, it almost does not change, does not bind to hemoglobin; is dissolved in the plasma. After cessation of inhalation, it is excreted (completely in 10–15 min) through the respiratory tract unchanged.

Anesthesia with the use of nitrous oxide is used in surgical practice, operative gynecology, surgical dentistry, as well as for pain relief of childbirth. <Therapeutic analgesic anesthesia> (BV Petrovsky, S.N. Efuni) using a mixture of nitrous oxide and oxygen is sometimes used in the postoperative period to prevent traumatic shock, as well as for the relief of painful attacks in acute coronary insufficiency, myocardial infarction, acute pancreatitis and other pathological conditions, accompanied by pain, not stopped by conventional means.

Apply nitrous oxide in a mixture with oxygen using special devices 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, with a concentration of nitrous oxide of 70-75%, add more powerful drugs: halothane, ether, barbiturates.

For a more complete relaxation of muscles, muscle relaxants are used, and not only muscle relaxation is enhanced, but also the course of anesthesia is improved.

After cessation of nitrous oxide supply, in order to avoid hypoxia, continue to give oxygen for 4-5 minutes.

Nitrous oxide should be used with caution in cases of pronounced hypoxia and impaired diffusion of gases in the lungs.

For labor anesthesia, intermittent autoanalgesia is used using a mixture of nitrous oxide (40-75%) and oxygen using special anesthetic devices.