So it’s significant amount of analgesia the difference of course between it and morphine is that there is no respiratory depressant as opposed to morphine which is a strong respiratory depressant. Also with morphine the effect lingers on for a long period of time could be all day long or longer whereas nitrous is very rapidly eliminated. With regards to the anxiety relief the anxiolysis it’s similar to giving somebody valium or ativan and the amnesia is similar also.

Patients will get a feeling that time slows down for them and they may recall the whole procedure or they may recall only parts of it or they might think that the procedure was much shorter than it it really was. It’s extremely rapid onset and offsets and you can achieve the desired effect within usually within three to five minutes and then the offset is also within three to five minutes.

One of the most important aspects of nitrous is that it’s safe it’s one of the safest agents there is. There have been studies that have looked at millions of encounters involving dentistry and really the only side effect that they see is nausea and vomiting and that’s in a very small percentage if nitrous is used by itself usually less than one percent.

It has no effect on airway reflexes, it has no effect on cardiovascular status, it has no effect on respiratory status so it can be used on patients that have asthma or have copd for instance or patients that have heart disease. Another aspect that’s very important to its safety also is the fact that it’s so rapidly eliminated within a few minutes. These patients can get up off a procedure table go to the bathroom and walk over to a chair and usually within 15 minutes a half an hour are good to to drive themselves home.

It’s much safer to give an elderly patient something like nitrous as opposed to giving them something like valium which lasts all day long because the concerns obviously are you don’t know how significant uh the valium is going to affect them. Also what is going to be the effect later on when they go home are they going to be steady on their feet is there danger of them falling and hitting their head and whereas with nitrous the effect is gone so rapidly that that’s not a concern. The nitroseal system has been used in pediatric hospitals nationwide since 2010 over 135 000 encounters and with no negative effects.

There’s a growing concern among parents and physicians about the safety of general anesthesia in young patients two years old and younger. The concern is the effect of general anesthesia on the developing brain. There’s a desire to avoid general anesthesia if possible so and nitrous is one of the agents that was excluded from the list of agents that are of concern.