The Dental Learning Network

Nitrous Oxide Sedation Review

Chapter Four - Use in the Dental Office


Chapter 1: History of Nitrous Sedation

Chapter 2: Mechanism of Action

Chapter 3: Medical and Dental Uses

Introduction
Patient Understanding
Contraindications of
Nitrous Oxide Use

Documentation
Disinfection

Chapter 5: Abuse and Adverse Effects

Chapter 6: Conclusion

References

Post Examination

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Documentation

In this day and age of frivolous malpractice lawsuits, it is important to document all aspects of any given procedure. The details concerning the administration of nitrous oxide sedation must be added to your post procedural write-up. The details that must be included are the percentage of nitrous given, the percentage of oxygen given, the length of time the patient was sedated and the flow of gas administered. Also, if the patient had any negative or atypical reactions to the sedation, these should be included also. For the doctor's convenience, the percentage of nitrous oxide given could be included for easy reference during future appointments. This would avoid any tinkering during the procedure to reach an ideal therapeutic level, as this level has already been determined. For instance:

"Patient given 25% N2O/75% O2 for 45 minutes @ 7 L/min. Patient initially given 35% N2O/65% O2 and reported "slight uneasy feeling" in stomach - N2O level was subsequently adjusted and comfortable level of sedation achieved."

This is a very detailed description that can be tailored to fit each practitioner's style. For instance, if the patient experiences no ill effects, there is no need to document the patient's reaction to the sedation. If the patient has a serious negative reaction, they should be advised against having sedation performed in the future and the reaction should be noted in the chart.

Continue on to Disinfection