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ABSOLUTE CONTRAINDICATIONS
Ileo
Pneumothorax
Pneumopericardium
Pneumomediastinum
Enterothorax
Lung cyst
Middle ear surgery
Middle ear inflammation
Gas embolism
Craniocerebral trauma
Intraocular air bubble
Perforating eye injuries
Ocular fund operations
As nitrous oxide penetrates air-filled cavities and spaces
depending on the concentration gradient, it causes a local
increase in volume
Psychotropic drugs
Oral sedatives
Drug addiction
Alcoholism
Interactions with the substances listed here are not
predictable.
Vitamin-B12/folic acid deficiency or associated disorders
Nitrous oxide oxidises the cobalt in vitamin B12,
interfering with erythropoiesis.
Limited nasal respiration
Prerequisite for effective sedation
continuous nasal breathing
COPD chronic obstructive pulmonary disease
Since in patients with COPD (chronic obstructive
pulmonary disease) the
respiratory stimulus driven by the
blood oxygen concentration, the
administration of oxygen during the
sedation could suppress this
stimulus.
Increased intracranial pressure
Alteration of the blood-brain barrier
In these patients, extravasation of fluids can lead to
increased
intracranial pressure.
Left ventricular failure
Right heart load
Nitrous oxide has an effect on the
cardiodepressive (Follow ASA classification).
Bleomycin therapy
Up to 18% of patients treated with
bleomycin develop pulmonary fibrosis.
Pregnancy
Embryonic damage cannot be excluded.
Personality disorders/severe behavioural abnormalities
psychosis/phobias
The action of nitrous oxide may lead to a worsening of
symptoms in these patients.
Cystic fibrosis (mucoviscidosis)
Mucoviscidosis involves chronic inflammation of the
airways.
Drug addiction or withdrawal
Nitrous oxide can cause undesirable behaviour.
Claustrophobia
Patients often do not tolerate the nasal mask.
RELATIVE CONTRAINDICATIONS
Disabled patients
Consultation with the treating physician is necessary as
pharmacotherapy is often complex. It must be ensured
that the patient breathes through the nose.
Seniors
Even in geriatric patients it is imperative to consult with
the attending physician.
(Taken from "Conscious sedation with nitrous oxide in the dental surgery - Wolfgang Lüder)
