Complications caused by nitrous oxide in dental sedation

ABSTRACT

The first clinical application of nitrous oxide (N₂O) was in 1844, by an American dentist named Horace Wells who used it to control pain during tooth extraction. Since then, N₂O has shared a 170-year history with modern dental anesthesia. N₂O, an odorless and colorless gas, is very appealing as a sedative owing to its anxiolytic, analgesic, and amnestic properties, rapid onset and recovery, and, in particular, needle-free application. Numerous studies have reported that N₂O can be used safely and effectively as a procedural sedation and analgesia (PSA) agent. However, N₂O can lead to the irreversible inactivation of vitamin B12, which is essential for humans; although rare, this can be fatal in some patients.