Nitrous oxide, commonly known as “laughing gas,” is a widely used and generally safe sedative in pediatric medical and dental procedures. When administered by trained professionals, it helps children manage anxiety and discomfort. This approach is broadly accepted by leading organizations such as the American Academy of Pediatric Dentistry (AAPD).
What Nitrous Oxide Is and Its Purpose in Pediatric Care
Nitrous oxide is a colorless and odorless gas, often called “laughing gas” for its calming effect. Its primary purpose in pediatric care is to alleviate anxiety, discomfort, and promote cooperation in children during various procedures. It helps raise the pain reaction threshold and can reduce a sensitive gag reflex. Children remain conscious and responsive throughout its use, distinguishing it from general anesthesia. This allows them to communicate with the healthcare provider, fostering a more positive experience.
How Nitrous Oxide is Administered to Children
A small, comfortable mask is gently placed over the child’s nose, through which a mixture of nitrous oxide and oxygen is inhaled. The child breathes normally through the mask, and the effects begin within a few minutes. Children may describe feelings such as lightheadedness, a tingling sensation in their limbs, or a floating feeling. They might also experience a giggly or relaxed state.
Ensuring Safety During Administration
Only healthcare providers with specific training in pediatric sedation should administer this gas. The concentration of nitrous oxide is precisely controlled and adjusted based on the child’s individual response. Continuous monitoring of the child’s vital signs, such as oxygen levels, heart rate, and respiratory rate, is maintained throughout the procedure.
Nitrous oxide is always administered with a significant percentage of oxygen, never falling below 25-30% oxygen concentration. This ensures the child receives adequate oxygenation while receiving the sedative. Once the procedure concludes and the mask is removed, pure oxygen is administered for several minutes to help flush any remaining nitrous oxide from the child’s system. The effects of the gas wear off quickly, within minutes, allowing the child to return to their normal state without lingering sedative effects.
Potential Side Effects and When Not to Use It
While generally well-tolerated, some children may experience mild, temporary side effects from nitrous oxide. These can include nausea, vomiting, dizziness, headache, fatigue, or a brief period of shivering or irritability. Such reactions are short-lived and resolve quickly once the gas is discontinued. Serious side effects are uncommon when nitrous oxide is administered appropriately.
There are specific situations or medical conditions where the use of nitrous oxide may not be suitable or requires careful consideration. These include children with certain respiratory conditions, such as severe asthma or a recent cold causing nasal obstruction. It is also generally avoided in patients with certain middle ear issues, recent eye surgery, or specific vitamin deficiencies. Children with severe emotional disturbances or those unable to cooperate with the mask may also not be ideal candidates. Healthcare providers carefully review a child’s medical history before deciding to use nitrous oxide.