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Sedation > Nitrous oxide > Flashcards

Nitrous oxide Flashcards

1
Q

When was nitrous oxide first used?

A

1844

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2
Q

Properties of nitrous oxide

A

Colourless
odorless
non irritating
nonflammable

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3
Q

What is the most toxic contaminant of nitrous oxide

A

nitric oxide

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4
Q

what is the major contaminant of nitrous oxide

A

nitrogen

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5
Q

how is nitric oxide toxic

A
  • highly reactive
  • oxidises pulmonary mucosa leading to pulmonary edema
  • oxidises hb so it cannot carry o2
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6
Q

What is the blood:gas partition coeff of nitrous oxide?

A

0.47

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7
Q

does nitrous oxide bind with hb?

A

no

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8
Q

does nitrous oxide transform within the body?

A

no

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9
Q

what patients should avoid nitrous oxide and why?

A

bowel obstruction, otitis media, recent eye surgery using perfluoropropane and pneumothorax because of possibility of high gas volume and pressure

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10
Q

What is the MAC deliverable by a dental unit?

A

0.5 because of leakage, dead space and mouth breathing

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11
Q

actions of nitrous oxide

A
  • mild analgesia

- depressed response to hypercapnia and hypoxemia

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12
Q

What happens if nitrous oxide is given with sedatives and opioids?

A
  • changes cardiovascular function if used with sedatives and opioids
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13
Q

What is the concentration of n2o of patient can feel tingling of hands and feet?

A

10-20%

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14
Q

what is the % of n2o if patient can feel circumoral numbness?

A

20-30%

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15
Q

Droning sounds are an indication of what % of n2o?

A

20-40%

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16
Q

When does numbness of tongue begin to set in with n2o?

A

20-40%

17
Q

Dysphoria and increased sleepiness at what stage?

A

30-50%

18
Q

Do you give n2o to a person with a URTI or sinus blockage?

A

absolutely not

19
Q

what can prolonged exposure to n2o cause?

A

myeloneuropathy

20
Q

N2o in child with MTHF reductase deficiency - is it safe?

A

no - can lead to death

21
Q

Major action of n2o

A

Oxidises cobalt atom in reduced vitamin b12

22
Q

which enzymes is vitamin b12 essential for?

A

methionine synthase
methylmalonyl coa mutase
leucine 2,3- aminomutase

23
Q

What reactions are facilitated by the increase in methionine due to n2o?

A
  1. protein synthesis
  2. Methylation of DNA, RNA, proteins, membrane phospholipids
  3. Antioxidant activity

Sedation (3 decks)

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