Current status of nitrous oxide use in pediatric patients

Table 1 Advantages and disadvantages of nitrous oxide use for anesthesia

Advantages	Disadvantages
Analgesia	Low potency
Reduced awareness	Risk of diffusion hypoxia
Colorless and odorless	PONV [risk ratio 1.21 (CI: 1.04-1.40); P = 0.014]2
Inexpensive (Rs 50/patient)1	Ability to expand air filled cavities
Faster onset and emergence (elimination half-life 5 min)	Increases cuff pressure of ETT and LMA
Minimal metabolism (< 0.004%)	Hematological/neurological toxicity
Cardiorespiratory stability	Immune deficiency?
Prevents CPSP	Reproductive effects
Treatment-resistant refractory depression	Myocardial ischemia?
	Greenhouse gas
	Apoptosis in developing brains

¹Cost of nitrous oxide used in dentistry in Indian rupees per patient.

²Risk ratio for the overall effect of nitrous oxide on postoperative nausea/vomiting.

PONV: Postoperative nausea/vomiting; CPSP: Chronic postsurgical pain; ETT: Endotracheal tube; LMA: Laryngeal mask airway; CI: Confidence interval.