chapter 16 Inhalation Sedation: Complications
INADEQUATE OR INCOMPLETE SEDATION
Patients who are emotionally or psychologically unstable may not fare well with N2O-O2. Patients who use mind-altering drugs may also have residual conflicting or counterproductive effects from N2O administration. These patients, particularly if chronic abusers, may be “resistant” to the effects of N2O and/or expect or require a level of potency that is beyond the capacity of N2O in therapeutic percentages. Hyporesponders, representing approximately 15% of the population, may not respond to the highest levels of N2O that can possibly be given (70% concentration). N2O-O2 use is also not intended for severely fearful patients. Choose your patient carefully and be mindful that N2O-O2 works best in conjunction with local anesthetic.1
POOR PATIENT EXPERIENCE
The primary reason to administer N2O-O2 is to provide a pleasant experience for the patient by altering his or her mood. Anything less is unacceptable. Some patients can have an inexplicable idiosyncratic reaction to a drug, but this is extremely rare with N2O, and there are no true outright contraindications, only relative contraindications. The relative contraindications of N2O-O2 are discussed in Chapter 12.
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