Nitrous Oxide

What is it?

Nitrous oxide is a colorless, odorless gas that you can mix with oxygen and breathe in to help with relaxation during an in-office varicose vein procedure.

How does it work?

Nitrous oxide (N2O) on its own can only be used safely for very short lengths of time because the lack of oxygen can lead to unconsciousness and even death. It is safe to use when it is mixed with oxygen. The length of administration and concentration of nitrous oxide and oxygen can deliver four different levels of sedation.

  • You may feel a tingling sensation in your arms and legs or a feeling of vibration.
  • You may feel a sensation of warmth throughout your body.
  • You may experience a feeling of euphoria, floating or well-being.
  • Sleepiness and difficulty keeping your eyes open and speaking are noted (this is over sedation).

It is normal to experience symptoms from any of the first three levels when you are properly sedated. If you experience any unpleasant symptoms let the staff know or simply remove the mask.

The mechanism of action for nitrous oxide is still unknown. It is known that nitrous oxide depresses almost all forms of sensation such as touch, pain and hearing. It can also disinhibit the emotional centers of the brain. Memory, concentration and performing intelligent acts are minimally affected with nitrous oxide.

How is it administered?

Nitrous is administered through many different types of mask that cover the mouth and nose. It can be given in different concentrations ranging from 50% nitrous oxide and 50% oxygen to 30% nitrous oxide and 70% oxygen. In our office we administer the 50% nitrous oxide and 50% oxygen mixture. Every office is different and you may experience a different response with each time it is used. Nitrous oxide can be given continuously through the mask or it can be given by demand only when you breathe in. The nitrous oxide mixture needs to be recaptured into a vacuum machine and ventilated to the outside.

Nitrous oxide works very quickly reaching the brain with-in 20 seconds if inhalation and causing the relaxation and pain killing properties in 2-3 minutes. There is no hangover effect after the administration of nitrous oxide, the gas is eliminated from your body 3-5 minutes after the gas supply is removed.

Nitrous oxide is contraindicated in patients with multiple Sclerosis, emphysema and during the first trimester of pregnancy.

Nitrous oxide has been used in Dentistry since 1863 and has been proven safe for many years.

Pre-Operative Medication for Vein Treatment

As a provider at IVC I commonly get the question “should I take Valium for my procedure?” I hope this will provide a little more information on what Valium is and how it can be used most effectively. During consultation with the patient the nurse practitioner/physician assistant will give you the option of getting a prescription for Valium if you will be returning to clinic for an ablation, sclerotherapy, or ambulatory phlebectomy. We offer 1 – 10 mg tablet per procedure to be taken orally 1 hour prior to procedure with instructions of having someone to drive you to the clinic before your procedure and to drive you home after your procedure is finished.

What is Valium?

Valium belongs to a class of drugs called benzodiazepines. The generic name for Valium is diazepam. Valium is specifically used in our clinic to help reduce the anxiety a patient may have prior to/during treatment. Valium has a half-life of 30-60 hours, though most patients feel the medication wearing off after 6-8 hours as it is prescribed as a small single dose. We prescribe valium to be taken orally as a single 10 mg tablet, though it can be dosed as low at 2 mg. The maximum daily dose that can be taken is 40mg per day (this should not be taken in a single dose). Valium specifically works by inhibiting neurotransmitters, this causes skeletal muscle relaxation, hypnosis, and sedation. The most common side effects of taking valium are drowsiness, dizziness, and muscle weakness. We ask all nursing mothers to pump and dump breastmilk for 24 hours after taking the tablet.

Should I take Valium for my procedure?

In general most patients take Valium. This is a personal decision, though if you are the type of person that has anxiety and stress over treatment then Valium would be a good option for you to have a more pleasant experience during treatment. If you have any questions about your specific situation feel free to discuss this with your primary care provider or with your provider at IVC.