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:Nitrogen oxide is a medical one - not less than 98.0%.
    Description:Colorless gas without a smell.
    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:

    Nonspecifically interacting with the membranes of neurons, inhibits the transfer of afferent impulses to the central nervous system, changes the cortical-subcortical relationships. Has high analgesic activity. Small concentrations cause a feeling of intoxication and mild drowsiness.

    The analgesia stage is achieved within 2-3 minutes at a concentration of up to 80% and 20% oxygen in the gas mixture. After 6-8 minutes after a short, but quite pronounced stage of excitation, there is a stage of surgical anesthesia. General anesthesia is maintained at a concentration of nitrous oxide of 40-50% 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 in 3-5 minutes.Increases the heart rate, causes a narrowing of the peripheral vessels, can increase intracranial pressure, depressing breathing.

    Pharmacokinetics:

    Absorbed into the blood through the lungs. In the body is not metabolized, is in a dissolved state in the plasma. The half-life (T1/2) - 5-6 minutes; is output completely through the lungs, unchanged, after 10-15 minutes, a small amount - through the skin. Permeability through the blood-brain barrier (BBB) ​​and the placental barrier is high.

    Indications:

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

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

    Pain syndrome; with 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:

    Doses are selected individually.

    Dosing and Administration:

    Inhalation. Nitrous oxide is used in a mixture with oxygen (with an oxygen content of at least 30%) and other means for inhalation anesthesia with the help of special devices for gas anesthesia.

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

    For analgesia of childbirth use the method of intermittent autoanalgesia using a mixture of nitrous oxide (40-70%) and oxygen: the mother gives birth to inhaling the mixture at the appearance of harbingers of the fight and finishes inhalation at the height of the bout or to its end.

    To perform medical procedures requiring unconsciousness - inhalation 25-50% in a mixture with oxygen.

    For children, doses are selected individually.

    To reduce emotional excitement, prevent nausea and vomiting, and potentiate the effect, a premedication is shown: intramuscular injection of 1-2 ml of a 0.5% 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 general anesthesia - supraventricular arrhythmias, bradycardia, development or worsening of heart failure; after leaving the general anesthesia - diffuse hypoxia, postnarcosis delirium (sensation of anxiety, confusion, excitement, hallucinations, nervousness, motor excitement); nausea, vomiting, drowsiness; with prolonged use (2-4 days) - depression of bone marrow function, leukopenia, pancytopenia, respiratory depression, malignant hyperthermic crisis, postoperative chill.

    Overdose:

    Symptoms: bradycardia, arrhythmia, circulatory insufficiency, lowering blood pressure, hypertensive crisis, respiratory depression, delirium, acute hypoxia.

    Treatment: with bradycardia - the introduction of 0.3-0.6 mg of atropine,arrhythmias - correction of blood gases, circulatory failure and hypotension - introduction of plasma or plasma-means, 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 , if necessary, dantrolene (1 mg / kg) IV drip and continue the administration until the symptoms of the crisis disappear (maximum total dose of 10 mg / kg).

    To prevent recurrence of the crisis for 1 -3 days after the operation, dantrolen is administered orally or IV (4-8 mg / kg / day in 4 divided doses). Respiratory depression or inadequate ventilation postoperative necessitated dose reduction anesthetic (if it is used), airway and mechanical ventilation. 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 stopable atropine) and arterial hypotension, xanthine - arrhythmia. Fentanyl and its derivatives increase the effect on the cardiovascular system (reduction in heart rate and minute heart volume).

    Strengthens the effects of hypotensive (especially diazoxide, ganglion blockers, chlorpromazine, diuretics) and anticoagulant (coumarin and indanedione derivatives) drugs, as well as drugs that depress the central nervous system and breathing.

    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 higher concentrations.

    Form release / dosage:The gas is compressed.
    Packaging:

    0.62 kg in a cylinder with a capacity of 1 dm3.

    1.24 kg in a container with a capacity of 2 dm.

    3.1 kg in a container with a capacity of 5 dm3.

    6.2 kg in a container with a capacity of 10 dm3.

    24.8 kg in a container with a capacity of 40 dm3.

    31.0 kg in a container with a capacity of 50 dm3.

    Use cylinders made of carbon steel in gray with a black inscription "Nitrous oxide" ("nitrous oxide") on the circumference.

    Cylinders are equipped with a valve with a minimum pressure holding valve and a first-opening control device complete with instructions for medical use.
    Storage conditions:

    In a dry separate room or outdoors under a canopy that protects from atmospheric precipitation and direct sunlight, away from heating sources and open fire sources at temperatures from minus 35 ° C to plus 35 ° C.

    Keep out of the reach of children.

    Shelf life:

    5 years.

    Do not use after the expiry date indicated on the bottle.

    Terms of leave from pharmacies:For hospitals
    Registration number:LP-004075
    Date of registration:16.01.2017
    Expiration Date:16.01.2022
    The owner of the registration certificate:LINDE GAZ RUS, LLC LINDE GAZ RUS, LLC Russia
    Manufacturer: & nbsp
    Information update date: & nbsp26.01.2017
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