Re: Office Anesthesia

From: Kim Elise Goldman (goldman@calweb.com)
Thu Jan 31 08:08:51 2008


By the way, nitrous will relax a patient but it will not eliminate pain. It takes an apprehensive but cooperative patient and turns them into a less apprehensive patient. It does not take the place of local anesthesia nor narcotics.

HTH

Kim

On Jan 30, 2008, at 11:06 PM, Kim E. Goldman wrote:

> 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
>





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