Nitrous oxide (medication)

Nitrous oxide (as medication)
INN: nitrous oxide
Entonox CD cylinder and giving set
Combination of
Nitrous oxideanalgesic gas (usually 50%)
Oxygenmedical gas (usually 50%)
Clinical data
Trade namesEntonox, Nitronox, others
ATC code
Legal status
Legal status
  • 50/50 mix of nitrous oxide and oxygen: ℞ (prescription only)
Pharmacokinetic data
MetabolismNot metabolized
MetabolitesNone
Onset of action30 seconds[1]
Duration of action1 minute[1]
ExcretionExhaled
Identifiers
CAS Number
PubChem CID
DrugBank
ChemSpider
UNII
ChEBI
ChEMBL
Chemical and physical data
FormulaN2O
Molar mass44.013 g·mol−1
3D model (JSmol)
  • Nitrous oxide: [N-]=[N+]=O
  • Nitrous oxide: InChI=1S/N2O/c1-2-3
  • Key:GQPLMRYTRLFLPF-UHFFFAOYSA-N

Nitrous oxide, as medical gas supply, is an inhaled gas used as pain medication, and is typically administered with 50% oxygen mix. It is often used together with other medications for anesthesia.[2] Common uses include during childbirth, following trauma, and as part of end-of-life care.[2] Onset of effect is typically within half a minute, and the effect lasts for about a minute.[1]

Nitrous oxide was discovered between 1772 and 1793 and used for anesthesia in 1844.[3] It is on the World Health Organization's List of Essential Medicines.[4] It often comes as a 50/50 mixture with oxygen.[1] Devices with a demand valve are available for self-administration.[5] The setup and maintenance is relatively expensive for developing countries.[6][7]

There are few side effects, other than vomiting, with short-term use.[1][2] With long-term use anemia or numbness may occur.[2] It should always be given with at least 21% oxygen.[2] It is not recommended in people with a bowel obstruction or pneumothorax.[2] Use in the early part of pregnancy is not recommended.[1] It is possible to continue breastfeeding following use.[8]

  1. ^ a b c d e f "Anaesthesia UK : Entonox". www.frca.co.uk. 26 January 2009. Archived from the original on 31 October 2007. Retrieved 15 December 2016.
  2. ^ a b c d e f World Health Organization (2009). Stuart MC, Kouimtzi M, Hill SR (eds.). WHO Model Formulary 2008. World Health Organization. p. 20. hdl:10665/44053. ISBN 9789241547659.
  3. ^ Myers RL (2007). 100 Most Important Chemical Compounds, The: A Reference Guide: A Reference Guide. ABC-CLIO. p. 198. ISBN 9780313080579. Archived from the original on 2016-12-20.
  4. ^ World Health Organization (2021). World Health Organization model list of essential medicines: 22nd list (2021). Geneva: World Health Organization. hdl:10665/345533. WHO/MHP/HPS/EML/2021.02.
  5. ^ British national formulary : BNF 69 (69 ed.). British Medical Association. 2015. p. 878. ISBN 9780857111562.
  6. ^ Gregory GA, Andropoulos DB (2012). Gregory's Pediatric Anesthesia, With Wiley Desktop Edition. John Wiley & Sons. p. 1148. ISBN 9781444333466. Archived from the original on 2016-12-20.
  7. ^ WHO model prescribing information : drugs used in anaesthesia. World Health Organization. 1989. hdl:10665/41014. ISBN 92-4-140101-X.
  8. ^ "Nitrous Oxide use while Breastfeeding". Drugs.com. Archived from the original on 21 December 2016. Retrieved 15 December 2016.