Laughing Gas- N2O

“if we couldn't laugh we would all go insane."

1)What is Laughing Gas?

Nitrous oxide is a safe and effective sedative agent that is mixed with oxygen and inhaled through a small mask that fits over your nose to help you relax.

Nitrous oxide, sometimes called “laughing gas,” is one option your dentist may offer to help make you more comfortable during certain procedures. It is not intended to put you to sleep. You will be able to hear and respond to any requests or directions the dentist may have. Your dentist will ask you to breathe normally through your nose, and within a few short moments, you should start to feel the effects of nitrousw oxide. You may feel light-headed or tingling in your arms and legs. Some people say their arms and legs feel heavy. Ultimately, you should feel calm and comfortable. The effects of nitrous oxide wear off soon after the mask is removed.

Talk to your dentist about whether nitrous oxide would be a good option for you.

2)Preparation of Laughing Gas

  • Industrial method

Nitrous oxide is prepared on an industrial scale by careful heating of ammonium nitrate at about 250 C, which decomposes into nitrous oxide and water vapor.

NH4NO3 → 2H2O + N2O

  • Laboratory methods

The decomposition of ammonium nitrate is also a common laboratory method for preparing the gas. Equivalently, it can be obtained by heating a mixture of sodium nitrate and ammonium sulfate:

2NaNO3 + (NH4)2SO4 → Na2SO4 + 2 N2O+ 4 H2O.

Another method involves the reaction of urea, nitric acid, and sulfuric acid:

2(NH2)2CO + 2 HNO3+ H2SO4 → 2 N2O + 2 CO2 + (NH4)2SO4 + 2H2O.

3)Characteristics and Properties of Nitrous Oxide

The characteristics and properties of nitrous oxide are as follows:

  • It reduces or eliminates anxiety.
  • It cannot produce profound surgical anesthesia. It can be used as a substitute to local anesthesia in minor procedures (small restorations and a supplement to local anesthesia) but not in extensive procedures (extractions).
  • It reduces the gag reflex but not the cough reflex.
  • There is minimal or nonexistent toxicity when used on healthy patients for a reasonable length of time.
  • It is highly insoluble in blood and water (resulting in quick absorption and elimination by the patient).
  • Ninety-nine percent of its elimination from the body is through the lungs without significant bio-transformation (has minimal effect on other organ systems).
  • It is not metabolized through the liver (little interaction with other drugs except for enhancing the effects of sedative and anti-anxiety drugs).
  • It is heavier than air with a specific gravity of 1.53. This property is helpful when introducing nitrous oxide/oxygen to an extremely anxious patient by placing the nasal hood a few inches above an anxious patient with the nitrous oxide to descending into the patient’s nose, enabling gradual desensitization to the experience.
  • Is gas at room temperature, but when compressed into a cylinder becomes a liquid.
  • Is non-flammable, however, it can support combustion. (If placed near an open flame, will burn brighter.)
  • At extreme altitudes (above 10,000 feet), there is a need for an increase in concentration (~5%) to obtain the same effect.
  • Nitrous oxide is a colorless and virtually odorless gas with a faint, sweet smell. It causes central nervous system (CNS) depression and euphoria with little effect on the respiratory system.
  • The analgesic effect appears to be initiated by the neuronal release of endogenous opioid peptides with subsequent activation of opioid receptors and descending Gamma-aminobutyric acid type A (GABAA) receptors and noradrenergic pathways that modulate nociceptive processing at the spinal level. The anxiolytic effect involves activation of the GABAA receptor either directly or indirectly through the benzodiazepine binding site.
  • Nitrous oxide has rapid uptake, being absorbed quickly from the alveoli and in a simple solution in the serum.
  • It is relatively insoluble, passing down a gradient into other tissues and cells in the body, such as the CNS.
  • As nitrous oxide is 34 times more soluble than nitrogen in the blood, diffusion hypoxia may occur and administering 100% oxygen to the patient for 3-5 minutes once the nitrous oxide has been terminated is important.
  • Nitrous oxide causes minor depression in cardiac output while peripheral resistance is slightly decreased, thereby maintaining blood pressure.
  • N2O is inert at room temperature and has few reactions. At elevated temperatures, its reactivity increases. For example, nitrous oxide reacts with NaNH2 at 460 K (187 °C) to give NaN3:

           2NaNH2 + N2O → NaN3 + NaOH + NH3

The objectives of nitrous oxide/oxygen inhalation include:

  • Reduce or eliminate anxiety.
  • Reduce untoward movement and reaction to dental treatment.
  • Enhance communication and patient cooperation.
  • Raise the patient’s pain reaction threshold.
  • Increase tolerance for longer appointments.
  • Aid in the treatment of the mentally/physically disabled or medically compromised patients.
  • Reduce gagging.
  • Potentiate the effects of sedatives.

4)Uses of Nitrous Oxide

A 10-year-old girl receives nitrous oxide as an anesthetic in a hospital emergency room in France.

  • The best-known uses of nitrous oxide are as a medical anesthetic and analgesic. An anesthetic causes a patient to lose touch with all sensation of pain — and often lose consciousness — while an analgesic simply lessens the severity of the pain. Tylenol, for example, is an analgesic.
  • Worldwide, nitrous oxide is the No. 1 inhaled anesthetic in the medical profession, always administered as a 50/50 blend of nitrous oxide and pure oxygen. As a patient in the U.S., you're most likely to encounter nitrous oxide at the dentist's office, but in Europe, Canada, and Australia it's commonly used as a pain reliever during childbirth
  • The chief advantages of nitrous oxide as a pain reliever are that it delivers immediate and powerful analgesic effects and can be cut off just as quickly, with patients recovering full sensation within minutes of removing a nitrous inhalation mask. Emergency medical personnel use nitrous oxide for quick pain relief during a variety of medical situations, including heart attacks, severe burns, kidney stones, fractures, and dislocations.
  • So how does this gas work? When nitrous oxide is inhaled, the gas enters the bloodstream through the lungs and travels quickly to the brain, where it triggers the release of the body's natural opioids, endorphins, and dopamine. The anesthetic effect of nitrous oxide is achieved by temporarily stabilizing neuron activity in the brain.
  • In the food industry, nitrous oxide is a highly effective propellant for dispensing fatty liquids like oil and heavy cream. To dispense whipped cream, nitrous gas is compressed into a liquid and mixed with heavy cream inside sealed, pressurized canisters. Because the liquid nitrous oxide displaces all oxygen in the can, an unopened canister of whipped cream will never go rancid. Nitrous oxide is highly soluble in fat, and when the pressure inside the canister is released, the liquid nitrous instantly turns to gas, expanding the volume of the cream four-fold.
  • Another popular use of nitrous oxide is as a fuel additive in car racing. In an internal combustion engine, oxygen is critical for igniting the fuel injected into the engine. When nitrous oxide is heated to 570 degrees F (~300 C) — racing engines run hot — it splits into nitrogen and oxygen. Adding compressed nitrous oxide to an engine significantly raises oxygen levels, which translates to more fuel being burned and more horsepower.
  • The final popular use of nitrous oxide is as a recreational drug. More on the "buzz" and adverse side effects of nitrous oxide abuse.

5)Laughing Gas as a Drugs

How is it used?

The gas is inhaled, typically by discharging nitrous gas cartridges (bulbs or whippets) into another object, such as a balloon, or directly into the mouth.3 Inhaling nitrous oxide produces a rapid rush of euphoria and a feeling of floating or excitement for a short period of time.

Other names

Laughing gas, nitro, N2O, NOS, nangs, whippet, hippy crack, buzz bomb, balloons.

Effects of nitrous oxide

There is no safe level of drug use. Use of any drug always carries risk. It’s important to be careful when taking any type of drug.

Nitrous oxide affects everyone differently, based on:

  • The amount is taken
  • The user’s size, weight and health
  • Whether the person is used to taking it
  • Whether other drugs are taken around the same time

The following effects may be felt almost immediately and can last for a few minutes: 

  • Euphoria
  • Numbness of the body
  • Sedation
  • Giddiness
  • Uncontrolled laughter
  • Uncoordinated movements
  • Blurred vision
  • Confusion
  • Dizziness and/or light-headedness
  • Sweating
  • Feeling unusually tired or weak
  • Sudden death

If a large amount of nitrous oxide is inhaled it can produce: 2,4,7

  • Loss of blood pressure
  • Fainting
  • Heart attack

Inhaling nitrous oxide can be fatal if you don’t get enough oxygen, which is known as hypoxia.

Long-term effects

Prolonged exposure to nitrous oxide may result in:

  • Memory loss
  • Vitamin B12 depletion (long-term depletion causes brain and nerve damage)
  • Ringing or buzzing in the ears
  • Incontinence
  • Numbness in the hands or feet
  • Limb spasms
  • Potential birth defects (if consumed during pregnancy)
  • Weakened immune system
  • Disruption to reproductive systems
  • Depression
  • Psychological dependence
  • Psychosis

Mixing with other drugs

There is no current evidence demonstrating that mixing nitrous oxide with other substances increases health risks. However, it is possible that combining the gas with stimulants and other drugs places additional pressure on the heart, increases blood pressure and may disrupt heart rate.5

Anecdotal evidence suggests that combining nitrous oxide with other drugs such as cannabis, ketamine, LSD, magic mushroom and saliva can cause intense dissociation.

Mixing nitrous oxide and alcohol can cause:

  • Confusion
  • Feeling heavy or sluggish
  • Reduced concentration
  • Loss of body control

Health and safety

When inhaling directly from tanks or whippets (bulbs), the gas is intensely cold (-40C degrees) and can cause frostbite to the nose, lips and throat (including vocal cords).5,10 As the gas is also under constant pressure, it can cause ruptures in lung tissue when inhaled directly from these containers. Releasing the nitrous oxide into a balloon helps to warm the gas and normalise the pressure before inhaling.5,8

People can also harm themselves if they use faulty gas dispensers, which may explode. Dispensing several gas canisters consecutively with one cracker (a handheld device used to ‘crack’ a nitrous oxide bulb/whippet) can also cause cold burns to the hands.5

  • It is possible to reduce the risks associated with misusing nitrous oxide by not:
  • Using it alone or in dangerous or isolated places
  • Putting plastic bags over the head or impeding breathing in any way
  • Spraying near flammable substances, such as naked flames or cigarettes
  • Drinking alcohol or taking other drugs
  • Standing or dancing while inhaling, as the user may pass out3,5
     

Withdrawal

There are no significant withdrawal symptoms apart from cravings to use more nitrous.

6)Common Questions asked about Laughing Gas

Can laughing gas kill you?

If you breathe nothing but nitrous for 10 minutes you will die, but I don't think there's any evidence that nitrous kills people if you use it recreationally." But to some critics, the dangers are clear. Breathing in high concentrations of laughing gas can quickly reduce the blood's level of oxygen.

Does laughing gas kill brain cells?

Purposely making the human body pass out or by cutting circulation off to the brain does not only kills brain cells but can create numbness in extremities, B12 deficiencies, suffocation, and it can even lead to death.

What does nitrous oxide do to your brain?

Nitrous oxide slows down your brain and your body's responses, and the effects of the drug varies depending on how much has been inhaled. Taking nitrous oxide can cause feelings of euphoria, relaxation, and calmness. fits of giggles and laughter – hence the nickname 'laughing gas'

What are the side effects of inhaling nitrous oxide?

This may occur when the level of nitrous is too high in the gas mixture or from a sudden change in the amount of nitrous oxide inhaled. Negative side effects may include nausea or vomiting, headache, increased sleepiness, and/or excessive sweating or shivering.

Is laughing gas dangerous?

Since nitrous oxide can cause dizziness, dissociation, and temporary loss of motor control, it is unsafe to inhale while standing up. Inhalation directly from a tank poses serious health risks, as it can cause frostbite since the gas is very cold when released.

Is nitrous illegal in cars?

Street legality. Nitrous oxide injection systems for automobiles are illegal for road use in some countries. ... In Germany, despite its strict TÜV rules, a nitrous system could be installed and used legally in a street driven car.

How long does nitrous oxide high last?

Effects of nitrous oxide. The effects may start to be felt immediately and can last from 2 – 3 minutes; some effects may last up to 30 – 40 minutes. Physical effects may include initial "rush" or "high".

Is nitrous oxide harmful to humans?

At normal environmental concentrations, nitrous oxide is not harmful to humans. Inhalation of higher concentrations in an enclosed space could, however, exclude oxygen - causing dizziness, nausea and eventually unconsciousness.

What are the long term effects of nitrous oxide?

Long-term effects. Prolonged exposure to nitrous oxide may result in Memory loss. Vitamin B12 depletion (long-term depletion causes brain and nerve damage).

Is laughing gas at the dentist dangerous?

Nitrous oxide is a safe and effective sedative agent that is mixed with oxygen and inhaled through a small mask that fits over your nose to help you relax. Nitrous oxide sometimes called “laughing gas” is one option your dentist may offer to help make you more comfortable during certain procedures.

Is Nos legal in Australia?

Across Australia, the sale of nitrous oxide canisters to whip cream is legal. However, some states and territories, including NSW, Victoria, South Australia, and the Northern Territory, have made it an offense to supply them to anyone who they believe intends to misuse them.

Is nitrous oxide detectable in a drug test?

Inhaled nitrous oxide can be detected in blood or urine shortly after exposure using special techniques and precautions,14 but it is not detected on results of routine drug screening panels.

Does laughing gas help during a root canal?

Nitrous oxide, better known as “laughing gas” or “happy air,” is used to help calm a child during their treatment. It is also recommended if your child needs an extensive dental procedure, such as a filling, crown, bridge, root canal, tooth extraction, periodontal treatment or cosmetic procedure.

What does nitrous oxide do for the body?

Nitric oxide is produced by nearly every type of cell in the human body and one of the most important molecules for blood vessel health. It's a vasodilator, meaning it relaxes the inner muscles of your blood vessels, causing the vessels to widen. In this way, nitric oxide increases blood flow and lowers blood pressure.
 

Author,

Raviprakash Tiwari