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Inhalation Sedation in Northwood

Is inhalation sedation safe?

Inhalation sedation is remarkably safe and is rarely associated with adverse effects. Inhalation sedation uses a combination of nitrous oxide (N2O) and oxygen (O2) and has been described as "representing the most 'ideal' clinical sedative experience". Interestingly, the actual mechanism of action of N2O is not completely understood!

However, it's been observed that N2O affects almost all forms of sensation - especially hearing, touch and pain, and that it seems to disinhibit some emotional centres in the brain. The ability to concentrate or perform intelligent acts is only minimally affected for a short period of time, as in memory.

How is it administered?

The equipment used for delivering Inhalation sedation is quite simple. It consists of a supply of compressed gases and an apparatus which delivers the gases to the patient. The desired N2O-O2 mix is fed through a tube to which a nasal hood (mask) or cannula is attached. This hood is put over the patient's nose and they just breathenormally.

What are the advantages?

The onset of the effects of N2O will be seen within 2-3 minutes, with the peak effect being reached in 3-5minutes. With N2O, it's easy to give incremental doses until the desired action is obtained (this is called "titration") and the administrator has absolute control over the action of the drug, preventing the possibility of accidental overdoses. While giving incremental doses is possible with IV sedation, it's not possible with oral sedation (as a result, oral sedation can be a bit of a hit-and-miss affair). The depth of sedation can be altered from moment to moment, allowing the person who administers the gas to increase or decrease the depth of sedation, unlike other sedation techniques. For example, with IV sedation, it's easy to deepen the level of sedation, but difficult to lessen it. Whereas with inhalation sedation the effects are almost instant! Other sedation techniques have a fixed duration of action, whereas inhalation sedation can be given for the exact time span it's needed for. It can also be switched off when not needed and then switched on again. The technique does not involve the use of an injection, a particularly important aspect for patients who are anxious about needles.

There's no "hangover" effect with inhalation sedation – the gas is eliminated from the body within 3-5 minutes after the gas supply is stopped. The recovery is extremely quick and adult patients can safely drive home and without an escort.

Inhalation sedation is very safe because it is not metabolised to any significant extent and can therefore be used on the majority of patients. Inhalation sedation produces some degree of analgesia, although not enough to allow pain free treatment, it will reduce the discomfort for certain procedures, such as the administration of local anaesthetic or the placement of gingival retraction cord. Additionally inhalation sedation has been found to be very effective in eliminating or at least minimising severe gagging.

Are there any disadvantages?

Some people are not comfortable with the nasal hood because it may remind them of a previous experience with general anaesthetic, or due to an inability to breathe through the nose with the mouth open. The technique is reliant to a certain extent on the operator's suggestions and reassurance. Inhalation sedation hasn't been proven to be safe during the first trimester of pregnancy, and it is not suitable for people who have a cold or some other conditions which prevent them from breathing through their nose.

A full medical examination will be performed to see if the patient is fit to use inhalation sedation.