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Sedation Accreditation > N2O Inhalation Sedation > Flashcards

N2O Inhalation Sedation Flashcards

1
Q

Indications for IHS

A

Dental anxiety
Young age
Short procedures
ASA I-II
Needlephobia

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2
Q

Contraindications for IHS

A

ASA III+
Nasal obstruction/snoring/apnoea
Lengthy surgical procedure
Extreme anxiety
Behavioural issues

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3
Q

Functional properties of N2O

A

Anxiolytic
Mild analgesic
Hypnotic
Odourless/colourless

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4
Q

Chemical properties of N2O

A

Low solubility/low blood-gas coefficient 0.47
High MAC 105%
Low partial pressure
Fast recovery
No metabolites

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5
Q

N2O pressure of storage
N2O gravity

A

43.5 Bars
Gravity of 1.53

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6
Q

Physical effects of N2O

A

CNS depression
Mild respiratory depression
Minimal effect on CVS

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7
Q

Mechanism of analgesia N2O

A

Interacts with opioid receptors in mid brain
Triggers peptide release
Mild depression CNS

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8
Q

Mechanism of anxiolysis N2O

A

Interacts with GABA receptors
Suppressed nervous system activity

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9
Q

Small increase in [N2O] will lead to

A

Rapid increase in uptake and rise in partial pressure of gas in tissues

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10
Q

Signs of sedation

A

Conscious
Light headed/dissociating/partial analgesia
Lethargy
Warm feeling
Vital signs normal
Normal response to verbal comments
Reduced gag reflex
Reduced response to stimuli
Tingling/relaxed feeling

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11
Q

Signs of oversedation

A

Loss of verbal contact
LoC
Loss of cooperation
Nausea/vomiting urge
Increased heart rate

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12
Q

Oversedation is managed by

A

Reducing N2O by 5-10%
Monitoring signs and symptoms
Continuing or postponing treatment

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13
Q

Stages of sedation

A

Plane 1-3

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14
Q

Plane 1

A

5-25% N2O
Awake
Gag reflex slightly reduced
Tingling/relaxed feeling

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15
Q

Plane 2

A

30-50% N2O
Dreamy look/light/heavy feeling

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16
Q

Plane 3

A

50%+ N2O
Total analgesia
Loss of contact/LoC
Loss of cooperation

17
Q

N2O technique is

A

Semi-hypnotic
Produces physiological changes whilst maintaining reflexes

18
Q

Advantages of N2O

A

Rapid 2-3 minute onset
Rapid 3-6 min recovery
Flexible duration
No adverse effects on system

19
Q

Disadvantages of N2O

A

Space required
Technique sensitive
Relies on patient co-operation

20
Q

Hazards - Types

A

Reproductive
Neurological
Haematological

21
Q

N2O main adverse effect

Chemical effect

A

Oxidation of B12 cobalt ion

22
Q

Oxidation of B12 affects action of - which is in involved in -

A

Methionine synthase
DNA synthesis

23
Q

Adverse effects of N2O

A

Reduced DNA synthesis
Bone marrow suppression
Hepatic disease
Reproductive issues
Diffusion hypoxia - N2O displaces O2 in alveoli - 100% inspired N2O

24
Q

Maximum recommended exposure for clinicians

A

100ppm over 8 hour period

Sedation Accreditation (5 decks)

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