Nitrous Flashcards
_____ synthesized nitrous.
_____ discovered anesthesia.
Priestley
Wells
Analgesic/Anxiolytic agent causing CNS depression and euphoria with little effect on the respiratory system.
Nitrous
Minimally impairs reflexes, thus protecting the cough reflex.
Nitrous
Nitrous is the least potent ________.
general anesthetic
Where is nitrous held in the blood?
Serum
Measure of potency.
MAC
Concentration of gas needed to produce immobility in 50% of patients.
MAC (minimum alveolar concentration)
Nitrous causes analgesia bc it causes:
Release of endogenous opioids.
Nitrous causes anxiolysis bc:
Activates GABA receptors
________ + ________ = successful injection
Nitrous + Distraction
Nitrous will not eliminate the need for this, except in minor dental procedures.
Local anesthetic
Continue this while using nitrous
Behavior guidance techniques
Nitrous reduces this reflex.
Gag
Nitrous is used when this can’t be obtained.
profound local anesthesia
Nausea and Vomiting from nitrous increase when you have:
1) Longer administration
2) Fluctuations in nitrous oxide levels
3) Increased concentration of nitrous
4) Rapid induction and reversal (no titration)
Ideal percent nitrous for kids.
30-40%
Contraindications to nitrous
Can Everyone Please Be More Conscientious
C E P B M C
COPD Emotional Disturbances Pregnancy (first trimester) Bleomycin Sulfate Tx MTHFR deficiency Cobalamin deificiency
Can patients with asthma receive nitrous?
Yes bc it’s not irritating to the tissues
Can nitrous be used for patients with a hypoxic drive?
No bc you eliminate their drive to breathe.
Lack of oxygen causes them to breathe.
Hypoxic drive
Anti-neoplastic drug used to treat certain types of cancer.
Bleomycin sulfate
Why is MTHFR deficiency a contraindication to nitrous?
Because people with MTHFR deficiency have increased homocysteine levels in the body.
Nitrous increases homocysteine levels as well, exacerbating the problem.
Why is nitrous contraindicated in patients with Cobalamin deficiency?
Bc it irreversibly oxidizes the Cobalt atom in Vit B12
Cobalamin is what vitamin?
B12
Why is nitrous contraindicated in patients with acute otitis media, bowel obstruction, or recent retinal surgery?
Because nitrous expands gas-filled spaces, like the middle ear, retina, and bowels, and can cause pain or rupture of the space.
Has there ever been a known reported allergy to nitrous (N20)?
no
Gas flow goal of nitrous.
Match tidal volume to gas flow.
The amount of air moved into or out of the lungs during quiet breathing.
Tidal volume
Tidal volume in adults
500 mL
The amt of air moved into or out of the lungs in a minute.
Minute Volume
How to calculate minute volume.
(Tidal Volume)(Respiratory Rate)
Average minute volume
6-7 L/min
As we grow from child to adult _________ increases and ________ decreases.
Tidal volume
Respiratory rate
Minute volume for 4 y.o
4 L/min
Minute volume for adults
6 L/min
The reservoir bag should be _____ full and pulsate with each breath.
2/3
NItrous concentration should not exceed what?
50%
How are the palms when optimal sedation is achieved?
Warm and slightly moist
This nitrous induction technique is used for children who may be on the edge of losing coping abilities and need to be controlled quickly.
Rapid Induction Technique
Nitrous may be added to the oxygen prior to seating of the nasal hood in which patients?
Claustrophobic patients
When does diffusion hypoxia occur?
When nitrous concentrations are high (70%).
