Re: Office Anesthesia

From: Kim E. Goldman (goldman@calweb.com)
Wed Jan 30 21:04:51 2008


As a board certified oral and maxillofacial surgeon I need to chime in here and say, though it is not complicated you do need proper training to use nitrous, there are some contraindications, and no one should ever deliver nitrous with a system that doesn't have a fail safe valve preventing "blue gassing" someone (giving 100% nitrous). In addition you should have appropriate monitoring equipment (pulse oximetry) and equipment for resuscitation including the ability to deliver 100% 2 via face mask. Also you need a closed system with evacuation of the wasted nitrous, med gas line approval by the state in most states and there are OSHA and other regulations regarding what the facility must have to administer nitrous.

There are also state licensure laws for the delivery of nitrous (varies from state to state) and for conscious sedation and for general anesthesia as well as a national board for dental anesthesia.

Kim On Jan 30, 2008, at 9:14 PM, R. Daniel Braun wrote:

> Check with your insurance carrier and do an anesthesia residency.
> Look out for aspiration, make sure your oxygen tank doesn't run out
> in the middle of the procedure, and know how to do a Nitrous washout
> before you start doing this. When I was a resident, we gave nitrous
> to our attendings patients for deliveries. We had an aspiration
> pneumonia, we had one lady turn blue because the O2 tank ran out and
> there was no valve in the room to open another tank. (I took the
> mask off and let her breathe room air. Luckily she was able to get
> by that way and didn't have problems from all the nitrous still in
> her system.
>
> I always wondered how those dentists got away with it.
>
> Dan
>
> On Jan 30, 2008 5:54 PM, Andrew Folley <agfolley@hotmail.com> wrote:
> Has anyone ever used Nitrous Oxide for office anesthesia???
> Dentists use it or use to use it frequently. I have had no luck in
> eliminating the severe intense pain of the office Novasure which
> occurs during the 1-2 minutes of ablation. I thought the Nitrous
> Oxide might be a good solution???
>
> --
> R. Daniel Braun, MD FACOG(L) CMT
> Professor Emeritus
> Dept. of Obstetrics and Gynecology
> Indiana U. School of Medicine
>
> R. Daniel Braun
>
> "Science without Religion is LAME; Religion without Science is
> BLIND"
> Einstein 1941





use when must restrict search to only the ob-gyn-l forum...
Enter search keywords:
Returns per screen: Require all keywords:

Return to  OB-GYN-L Mail a New Message to the Forum: ob-gyn-l@obgyn.net
Forum Administrator: geffrey.klein@obgyn.net
Report Technical Problems: webmaster@obgyn.net
Last Updated: Mon Nov 2 05:10:13 2009

The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.