Use of Nitrous Oxide in Office-based Urologic Procedures: A Review

Nitrous oxide (N₂O) is underutilized in ambulatory urology. Here, we review available data regarding application, efficacy, and side effect profile of N₂O in ambulatory urologic procedures. Data were available from 11 studies. N₂O has been described in the setting of transrectal ultrasound-guided prostate biopsies, flexible cystoscopy, ureteral stent placement, and extracorporeal shockwave lithotripsy in adult patients and catheterization in children. Studies showed significant improvements in peri-procedural pain and anxiety relative to alternative (or none) forms of analgesia. Adverse effects were rare and self-limited. More widespread use of N₂O may result in cost savings and better patient tolerance with outpatient procedures.