is nitrous oxide used by itself or in combination with another agent? if so, which agent?
It is used with oxygen
List four effects of nitrous oxide mixed with oxygen for conscious analgesia
- the pt remains conscious
- the protective reflexes are in tact
- relief of anxiety
identify the recommended dose of oxygen and that of nitrous oxide for conscious analgesia
50% of each
describe the procedure for administering nitrous oxide for conscious sedation, including pt responses.
- beging with 100% oxygen for 2-3 minutes
- add nitrous slowly in 10% increments - the onset of sedation occurs within 3-5 minutes
- have pt tell you when they feel tingling
- maintain the level where pt is comfortable
describe the cause of diffusion hypoxia and how it is prevented
- it is the rapid movement of large amounts of nitrous oxide from the circulation into the lungs which may dilute the oxygen in the lungs (headache)
- prevent it by having pt breath in 100% oxygen for 5 minutes after prodedure
how is the effect of nitrous oxide terminated?
list two used for nitrous oxide
- with other drugs to induce general anesthesia
- for conscious sedation and analgesia
Describe the effects of general anesthesia. What is the limitation?
- reversible depression of the CNS, loss of consciousness, amnesia, and immobility
- not complete analgesia
What is the primary site of action for general anesthetic agents?
Central nervous system
List the various types of drugs used to achieve general anesthesia.
- volatile gaseous and IV anesthetics
- nitrous oxide
- antianxiety agents
- neuromuscular blocking agents
List six goals of general anesthetic drugs.
- rapid loss of consciousness
- amnesia of surgical events
- minimal amount of time in the excitement phase
- stable plateau of surgical anesthesia
- appropriate levels of respiratory and cardiovascular responsiveness, and skeletal muscle relaxation
Note the clinical uses for general anesthetic agents. what drugs provide an amnesiac effect?
List drugs used to quickly move the pt through the excitement stage of general anesthesia.
Which is the safest of the general anesthetic agent?
Whic of the drugs in the general anesthetic combination provides for effective analgesia during surgery?
Compare recommended dose for induction of general anesthesia versus the dose for conscious sedation, what is the concentration for maintenance?
- GA induction - 60% N 40% O
- conscious sedation - 50%-50% or 40N - 50 O
- maintenance - 30% N - 70% O
list side effects or adverse drug effects for nitrous oxide. Which pts should not recieve nitrous oxide
- nausea, vomiting, delirium, no drug interactions, can cause headache
- pts who have had eye surgery within the past 3 months, pregnant pts
Identify potential occupational hazards of having nitrous oxide in the dental office
- fetal exposure, spontaneous abortion
- over exposure resulting in neuropathy