Nitrous oxide - a narcotic analgesic agent, used in surgery, operative gynecology, as well as generic anesthesia.
Description of the drug
Nitrous nitrogen gas is colorless and odorless, heavier than air (density of 1, 527). At a ratio of 1: 2 is capable of dissolving in water. At a pressure of 30 atmospheres and a temperature of 0 C and at a pressure of 40 atmospheres and ambient temperature is transformed into a colorless liquid. From 1 kg of liquid nitrous oxide is formed of 500 liters of gas.
In small doses, the use of the drug causes a slight feeling of intoxication and sleepiness. Hence another name - laughing gas. Inhalation of pure gas having asphyxia and narcosis. Medical nitrous oxide when the correct dosage is narcosis without excitation and other side effects.
The drug has no strong drug efficacy, and therefore it is expedient to use in combination with other types of anesthesia, more powerful.
Release cylinders nitrous gray having a capacity of 1 liter and 10 under the pressure of 50 atm.
Gas Nitrous oxide is chemically inert, non-irritating to the respiratory tract. Virtually no changes in the body, is not associated with hemoglobin. The plasma is in a dissolved state. After the cessation of breathing for a short period of time (10-15 minutes) is fully displayed in its original form through the respiratory tract.
Anesthesia occurs rapidly due to the low partial pressure between gas and blood. At a concentration of 65-70% of the anesthetic comes complete anesthesia and at a concentration of 35-40% is achieved analgesic effect. The gas concentration of more than 70% has the effect of hypoxia.
Indications for use of nitrous oxide
Anaesthesia using nitrous oxide cylinders are now widely used in surgical dentistry, operative gynecology, surgical practice.
Advantageously, in practice anesthetics Nitrous oxide gas is used as a component of combined anesthesia in combination with muscle relaxants, analgesics and other anesthetics (enflurane, Halothane, ether) with a mixture of oxygen (20-50%).
Also balloons with nitrous oxide is used in the extraction of teeth, removal of drainage tubes and joints in the postoperative period for removal of traumatic shock and facilitating other pathological conditions involving pain that is not relieved by non-narcotic analgesics.
Analgesia balloons with nitrous oxide, in addition to small surgical procedures performed in ambulances to patients with acute myocardial infarction, acute coronary insufficiency, acute pancreatitis, burns and severe mechanical injury.
Analgesia medical nitrous oxide with oxygen content of 50-60% effective in shock. The high oxygen content in the mixture to the same therapeutic effect gives oxygenation.
There may be nausea and vomiting after anesthesia.
When pronounced hypoxia (insufficient oxygen supply or violation of its assimilation and utilization), also in violation of diffusion (penetration) gases from the lungs into the blood, you should exercise extreme caution in the use of the gas nitrous oxide.
Contraindicated for use in patients with chronic alcoholism, severe diseases of the nervous system while intoxicated (subject to hallucinations and jitters).
Interaction with other drugs
Anesthesia balloons with nitrous oxide is well combined with epidural anesthesia in combination with other inhalation anesthetics (Halothane, cyclopropane, Trillo, ether), with intravenous drugs (barbiturates and triobarbituratami) with neuroleptics, and muscle relaxants. During operations required ratio of oxygen gas in a ratio of 2: 1 or 3: 1.
Prolonged anesthesia while using muscle relaxants there is harm from nitrous oxide - the accumulation of carbon dioxide and the subsequent development of hypoxia, which can cause cardiac abnormalities during the operation.
Another harm of nitrous oxide - the ability to strengthen the depressive effects of opioids and barbiturates on the respiratory center.
The safety of nitrous oxide and harm. The effect on body
Harm nitrous oxide and its negative impact on the respiratory, cardiovascular system, kidneys and liver are very small, so this narcotic drug is considered one of the safest.
Medical Nitrous oxide in concentrations of up to 80% practically safe for the body and has no negative impact on the function of vital organs.
For newborn harm arises from the nitrous oxide gas during prolonged inhalation of giving birth - the child may be born with low Apgar scores.
From the side of blood use of gas may cause slight variations. Identified harmful nitrous oxide for bone marrow function. With prolonged use (2-4 days) have a depression of bone marrow function and decreases the number of white blood cells.
Various experiments have revealed the harm of nitrous oxide on the growth and division of cells during long-term use. In the case of the treatment of tetanus prolonged use of the drug leads to agranulocytosis and myelodepression.