Active substanceDinitrogen oxideDinitrogen oxide
Similar drugsTo uncover
  • Nitrogen oxide
    gas d / inhal. 
  • Nitrogen oxide
    gas d / inhal. 
    STIROLBIOFARM, LLC     Ukraine
  • Nitrogen oxide
    gas d / inhal. 
    LINDE GAZ RUS, LLC     Russia
  • Dosage form: & nbspcompressed gas
    Composition:Dinitrogen oxide is 6.2 kg.
    Description:A colorless gas with a weak, specific odor or odorless. Does not ignite. Supports combustion.
    Pharmacotherapeutic group:Means for inhalation anesthesia
    ATX: & nbsp

    N.01.A.X.13   Dinitrogen oxide

    N.01.A.X   Other drugs for general anesthesia

    Pharmacodynamics:
    Means for inhalation anesthesia. Nonspecifically interacting with the membranes of neurons, inhibits the transmission of nerve impulses to the central nervous system, changes the cortical-subcortical relationships. Has a high analgesic activity. Small concentrations cause a feeling of intoxication and mild drowsiness.

    The analgesia stage is achieved within 2-3 min with the content of up to 80% nitrous oxide and 20% oxygen in the gas mixture. After 6-8 minutes after a short, but quite pronounced stage of excitation, I st. surgical anesthesia.

    General anesthesia is maintained at a concentration of 40-50% Dinitrogen oxide with a corresponding increase in oxygen supply.A sufficient relaxation of the skeletal muscles is not achieved. Therefore, nitrous oxide is combined with other means for inhalation anesthesia and muscle relaxants to achieve the desired effect. Awakening occurs 3-5 minutes after cessation gas supply. Increases the heart rate, causes a narrowing of the peripheral vessels, can increase intracranial pressure, depressing breathing.

    Pharmacokinetics:Through the lungs enters the systemic circulation. It is not metabolized, is in a dissolved state in the plasma. Output is completely unchanged through the lungs after 10-15 minutes, a small amount - through the skin, half-life - 5-6 minutes. Permeability through the blood-brain barrier and the placental barrier is high.
    Indications:

    Combined inhalation anesthesia (using special equipment) in combination with other anesthetics, muscle relaxants and narcotic analgesics.

    General anesthesia, which does not require deep anesthesia and muscle relaxation (in general surgery, operative gynecology, dentistry, for anesthesia of childbirth).

    Strengthening of anesthetic and analgesic effect of other anesthetics (including therapeutic analgesic anesthesia in the postoperative period), traumatic shock (prevention);

    Pain syndrome: acute coronary insufficiency, myocardial infarction, acute pancreatitis (cupping);

    Anesthesia in the performance of medical procedures requiring disconnection of consciousness.
    Contraindications:

    Hypersensitivity. Hypoxia; diseases of the nervous system; chronic alcoholism, the state of alcoholic intoxication (possibly the emergence of excitement and hallucinations).

    Carefully:Craniocerebral injury, increased intracranial pressure in the anamnesis, intracranial tumors.
    Pregnancy and lactation:Nitrous oxide is used as an inhalation for the anesthetization of labor. Prolonged use can provoke miscarriages or adversely affect the development of the child. However, in small concentrations (ratio to oxygen content 1: 1) and for a short time (for 2-3-х inhalations), the agent is prescribed if necessary. Contraindicated during lactation, therefore, if necessary, breastfeeding should be abolished.
    Dosing and Administration:

    Inhalation.

    Nitrous oxide is used in a mixture with oxygen and other means for inhalation anesthesia with the help of special devices for gas anesthesia. Usually start with a mixture containing 70-80% Nitrous oxide and 20-30% oxygen.

    To stop and prevent pain syndrome, medical anesthesia is carried out at a concentration of nitrous oxide 40-75%. To quickly achieve the required depth general anesthesia (lead anesthesia) concentration of dinitrogen oxide - 70-75%, maintenance of general anesthesia - 40-50%; if necessary - add more powerful drugs: barbiturates, fluorotane, ether. After stopping the supply of dinitrogen oxide, you should continue to supply oxygen for 4-5 minutes (to avoid diffusion hypoxia).

    For the anesthesia of childbirth use the method of intermittent autoanalgesia using a mixture of dinitrogen oxide (40-75%) and oxygen: the mother gives birth to inhaling the mixture at the appearance of harbingers of the fight and ends the inhalation at the height of the bout or to its end.

    To perform medical procedures that require disconnection of consciousness - inhalation of 25-50% of the mixture with oxygen. For children, doses are selected individually.

    Inhalation of the mixture can be at an oxygen content of at least 30%, and after stopping inhalation, it is necessary to continue supplying oxygen for 5 minutes (prevention of hypoxia). To reduce emotional excitement, prevent nausea and vomiting and potentiation of the action, a premedication is shown: intravenous injection of a 0.5 ml solution of diazepam (5-10 mg), 2-3 ml of 0.25% solution of droperidol (5, 0-7.5 mg).

    Side effects:During the introduction to anesthesia, supraventricular arrhythmias, bradycardia, circulatory failure. After leaving the general anesthesia - diffuse hypoxia, postnarcosis delirium (a sense of anxiety, confusion, excitement, hallucinations, nervousness, motor excitement). Nausea, vomiting, drowsiness; with prolonged use (more than 2 days) - respiratory depression, bone marrow dysfunction, manifested by leukopenia, pancytopenia, as well as hyperthermic crisis and postoperative chills.
    Overdose:

    Symptoms: bradycardia, arrhythmias, lowering of arterial pressure, respiratory depression, delirium, acute hypoxia.

    Treatment: with bradycardia - the introduction of 0.3-0.6 mg of atropine, arrhythmia - correction of the content of gases in the blood,circulatory insufficiency and arterial hypotension, - introducing the plasma or Plasma substitutes, depth decrease or cessation of general anesthesia, with hyperthermal Stroke - cessation of inhalation, the increased supply of oxygen introduction antipyretics, correction of the water-salt balance and metabolic acidosis when necessary - Dantrolene (1 mg / kg) intravenously drip and continue the administration until the symptoms of the crisis disappear (maximum total dose of 10 mg / kg). To prevent the crisis of relapse within 1-3 days after surgery dantrolene administered orally or intravenously (4.8 mg / kg / day in 4 divided doses). Respiratory depression or inadequate ventilation postoperative necessitated dose reduction anesthetic (if it is used) to ensure patency of the airways and ventilator. In the case of delirium development, after the withdrawal from general anesthesia, small doses of the narcotic analgesic are administered.

    Interaction:

    Means for inhalation anesthesia, narcotic analgesics, tranquilizers, neuroleptics, antihistamines increase the effect.

    Amiodarone increases the risk of bradycardia (not atropine-stopable) and arterial hypotension, xanthine - arrhythmia.

    Fentanyl and its derivatives increase the effect on the cardiovascular system (decrease in heart rate and minute heart volume).

    Strengthens the effects of antihypertensive drugs - diazoxide, ganglion blockers, diuretics, as well as anticoagulant drugs (coumarin and indanedione derivatives) and respiratory depressants and the central nervous system.
    Special instructions:

    It is necessary to control blood pressure, heart rate, heart rate, monitor breathing and gas exchange, body temperature. Medical staff with prolonged contact increases the risk of developing leukopenia. During use, periodic pumping of gas from the cuff of the endotracheal tube is recommended.

    Mixtures with ether, cyclopropane, chloroethyl at certain concentrations are explosive. Patients with chronic alcoholism require high concentrations.
    Children. Nitrous oxide is used for children. Possible use of infants. Doses are selected individually. For newborns Nitrous do not use nitrous oxide.
    Effect on the ability to drive transp.cf. and fur:Nitrous oxide acts mainly on the central nervous system, the drug is used as a means for inhalation anesthesia, and therefore do not apply when driving vehicles or working with other mechanisms.
    Form release / dosage:The gas is compressed.
    Packaging:At 6.2 kg in metal containers with a capacity of 10 liters.
    Storage conditions:At a temperature not higher than +25 ° С. Keep out of the reach of children.
    Shelf life:

    5 years.

    Do not use after the expiration date printed on the package.

    Terms of leave from pharmacies:For hospitals
    Registration number:P N016199 / 01
    Date of registration:28.05.2010 / 30.12.2011
    Expiration Date:Unlimited
    The owner of the registration certificate:STIROLBIOFARM, LLC STIROLBIOFARM, LLC Ukraine
    Manufacturer: & nbsp
    Representation: & nbspStirolbiopharm Ltd.Stirolbiopharm Ltd.
    Information update date: & nbsp23.06.2017
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