Children’s Hospitals and Clinics of Minnesota pioneered the development of a nurse-administered nitrous oxide sedation program designed to provide greater comfort for pediatric patients as they undergo stressful procedures. The following information highlights the unique components of the program, and offers tools and resources based on the success of Children’s program.

Why nitrous oxide?

Nitrous oxide (N2O) is a mild sedative anxiolytic, with analgesic and amnestic properties. Dentists have taken advantage of these properties since the 1840s. Although nitrous oxide sedation has been practiced in health care settings across Europe and Australia for years, studies on the use of nitrous oxide in pediatric patients in the United States began to appear in journals approximately 25 years ago (Griffen, G.C., Campbell, V.D., Jones, R. “Nitrous oxide-oxygen sedation for minor surgery – experience in a pediatric setting” JAMA 1981, Vol. 245:2411-3). More recent reports and studies conducted at Children’s Hospitals and Clinics of Minnesota confirm the safety and efficacy of nitrous oxide for pediatric patients.

Nitrous oxide produces “conscious sedation” with the patient remaining awake but calm throughout its administration. When children are relaxed, they are able to follow verbal instructions. Despite their “awake” state, up to 80 percent of children are unable to recall a painful procedure when nitrous oxide is used for sedation/analgesia.

Side effects

The relief provided by nitrous oxide administration is not accompanied by the side effects associated with other sedatives, including combativeness, which can occur in patients coming out of sedation. Additionally, when compared to other commonly used sedation drugs, nitrous oxide is shorter acting. Many children can walk out of their hospital visit without assistance after a brief recovery, and some older patients can actually return to activities, such as school, after a medical procedure.

In the first four years of the program, Children’s studied more than 4,800 patients for side effects and outcomes. The study revealed mild side effects that were well tolerated. Just over five percent of children experienced nausea or vomiting, which resolved quickly when the nitrous was discontinued.