Nitrous oxide analgesia for minor orthopedic procedures

The need for adequate analgesia to perform potentially painful procedures on our orthopedic patients is of paramount importance. Narcotics and tranquilizers, although effective, often cause prolonged somnolence lasting long after the orthopedic procedure is completed. Nitrous oxide, on the other hand, takes effect within minutes and its pharmacological effects subside rapidly upon termination of inhalation. The purpose of this study was to determine the effectiveness and safety of using nitrous oxide analgesia for minor orthopedic procedures. Thirty-seven patients were administered a 50% nitrous oxide/50% oxygen mixture. The orthopedic procedure was then performed followed by three minute nitrous washout with 100% oxygen. Twelve patients received conventional parenteral medications and were compared to the former group. Evaluation of the results following the administration of these two methods of analgesia revealed both to be relatively safe with the nitrous oxide having a significantly greater level of patient acceptance. At this medical institution it is now the preferred method of our orthopedic surgeons who routinely perform these procedures.