--
________________________________
Elise Goldman
Sent: Friday, 1 February 2008 2:12 AM
To: Multiple recipients of list OB-GYN-L
Subject: Re: Office Anesthesia
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
CONFIDENTIALITY NOTICE AND DISCLAIMER
The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately contact this office by telephone, fax or email, to inform us of the error and to enable arrangements to be made for the destruction of the transmission, or its return at our cost. No liability is accepted for any unauthorised use of the information contained in this transmission. If the transmission contains advice, the advice is based on instructions in relation to, and is provided to the addressee in connection with, the matter mentioned above. Responsibility is not accepted for reliance upon it by any other person or for any other purpose.
