What is Nitrous Oxide and how does it Work?

Nitrous oxide is a colorless gas. It is used to induce drowsiness and pain relief, in medical setups. Dentists and medical professionals commonly use it to sedate patients undergoing minor medical procedures. Nitrous oxide is a dissociative anesthetic that causes dissociation of the consciousness from the body (a feeling of floating), altered perceptions, and, in rare circumstances, visual hallucinations. 


Nitrous oxide is a colorless, odorless chemical gas made up of nitrogen molecules and an oxygen molecule. The patient is given nitrous oxide using a nasal hood that fits over his or her nose. The dentist will select the N2O-O2 gas mixture, turn on the equipment, and the gas will be pumped into the hood by the machine. To get the gas, all the patient has to do is inhale normally. Nitrous oxide reaches the brain in twenty seconds after inhalation and begins blocking pain receptors two to three minutes after the initial inhalation.

How does nitrous oxide works?

Although it is used widely as an anesthetic agent, the specific mechanism by which nitrous oxide works remains uncertain. The body’s ligand-gated ion channels are regulated by nitrous oxide. Ion channels that are ligand-gated are made up of transmembrane ion-channel proteins. In response to the binding of a ligand (chemical messenger), such as a neurotransmitter, these channels open, allowing ions such as Sodium, Potassium, Calcium, and Chlorine to pass through the membrane. In simple terms, ligand-gated channels control the flow of ions in the body, which controls how chemical messengers like neurotransmitters influence the body. 


Nitrous oxide has three major effects on the human body. GABAA receptors, which inhibit or block neurotransmitters, cause it to have an anti-anxiety effect. Second, it has an analgesic (painkiller) effect due to a chemical reaction in the brain that causes norepinephrine to be released, which suppresses pain signals throughout the body. Finally, nitrous oxide produces euphoria via increasing activation of the dopamine-releasing reward circuit in the brain.

These three physiological effects can be accomplished at varying levels of sedation. Depending on the quantity of gas a patient receives, they may have varied responses in response to the sedation. Patients report feeling light-headed, tingling in their arms and legs, warm, euphoric, and drowsy in general. Some people may feel as though they are floating or vibrating. 


The patient is given pure O2 through a mask after the treatment to flush any leftover NO2 from the lungs and airway. The patient will gradually return to their normal state during this time. Because nitrous gas can impair both appetite and driving abilities, patients should check with their dentist about when they can eat and/or drive after getting it. 


Benefits of using Nitrous Oxide in dental procedures: Dentists choose nitrous oxide as a sedative treatment because it is both safe and effective. By inhaling pure oxygen through a mask, the laughing gas works swiftly to calm patients, and the effects wear off quickly. Furthermore, because the nitrous gas does not put you to sleep, you will be able to hear and reply to any inquiries or directions from the dentist.


Side Effects after using Nitrous Oxide: Laughing gas has no known side effects in the majority of people. They can, however, develop if nitrous oxide concentrations increase too high or if the quantity breathed varies rapidly. Headaches, shivering, sweating excessively, vomiting or nausea, and sleepiness are some of the side effects of nitrous oxide as highlighted by the California Dental Association. 


To avoid headaches, patients must get oxygen for at least five minutes after the nitrous oxide has been switched off. The oxygen helps the patient become more aware and conscious by removing any leftover gas from the lungs. Patients can also assist reduce nausea and vomiting by eating lightly before the surgery and refraining from eating anything substantial for up to three hours afterward. 


It is best to confirm with the dentist to see if your driving can be done after the procedure.