Entonox for pain control and sedation
What is Entonox?
Entonox or Equanox or sometimes referred to as ‘laughing gas’ or ‘gas and air’, has been used in the NHS since 1965 for relieving pain and anxiety.
It is a 50/50% mixture of nitrous oxide and oxygen gas and is commonly used in childbirth and by the ambulance service for the relief of pain. Entonox works very quickly and its effects are felt almost immediately after inhalation, making it a very good pain relief with a relaxing effect without losing consciousness or control.
What are the benefits of using Entonox?
Entonox is used to reduce pain (a painkiller) and has a relaxing effect.
It is self-administered via a patient controlled on-demand face/ nasal/mouthpiece, therefore you are in full control of your own pain relief requirements. The effects of the entonox gas will be reached/felt after approximately 6 to 8 inhalations.
After stopping inhalation, the gas and its effects wears off. Within eight minutes it will have disappeared completely from your body. Due to this you will not need anyone to look after you for twenty four hours afterwards (a necessity after receiving injections of painkiller and sedative drugs for an endoscopic examination). Within thirty minutes of ceasing to breathe Entonox gas you can drive again (after receiving injections of painkiller/sedative drugs the patient cannot drive for twenty four hours).
Are there any risks?
There are no serious risks and very few side effects from inhaling Entonox gas. Occasionally you may feel some light headedness, some tingling in the fingers and face and a little sickness or dizziness. This usually happens if you are breathing the gas in and out too quickly, called 'hyperventilating'. If this does occur, the nurse will tell you to slow down your breathing to normal breathes and the side effects will stop. Entonox is not always suitable for everyone and there are conditions/illnesses where Entonox gas cannot be used.
These are -
- Any ear disorder or previous ear/eye surgery
- Any facial injuries
- Drunk/intoxicated patients
- Patients with head injuries
- Within 72hrs of diving using oxygen tanks
- Patients who have previously suffered the bends from deep sea diving
- Patients who are heavily sedated or unconscious
- Severe/bad COPD/asthma (oxygen levels which are normally below 94%)
- Previous chest injuries
- Any kind of previous pneumothorax (air in-between the lungs membranes)
- First 16 weeks of pregnancy
- Patients with laryngectomy (throat surgery)
A full assessment of your suitability for Entonox will be done upon admission.
How do you use Entonox?
Whilst being admitted by the nurse for your endoscopy procedure you will be shown the mouth/facial/nasal piece and instructed on how to breathe the Entonox gas in and out.
When the endoscopist is ready to start your procedure the nurse will tell you to start breathing in the Entonox gas and you will breathe the Entonox for about 2 to 8 breaths before your procedure starts.
This will give the Entonox time to take full effect and for you to feel comfortable using the gas. You will then breathe the Entonox throughout your procedure, and the nurse will tell you to breathe in and out as normal.
If you find the Entonox gas is unsatisfactory, then the endoscopist will assess you and offer an alternative, the decision of which will be made by the endoscopist performing the test.
Warning - This may be an injection of painkiller/sedative and you must be aware that after this you will require 24 hours aftercare by a responsible adult. You will not be able to drive/ operate machinery or sign any legal documents for 24 hours after your procedure.
What happens when I stop using Entonox?
After the procedure has finished, the nurse will tell you to stop breathing the Entonox gas and take away the mask/nasal mouth piece. The Entonox gas will take about 8 minutes to disappear completely from the body.
Benefits of choosing entonox for endoscopic procedures
As there are no lasting effects from breathing Entonox gas within 30 minutes, you will be able to drive home and carry on with your normal day without having anyone to look after you.
Contact Numbers
If you have any questions regarding the procedure or use of entonox, them please contact the Endoscopy Unit:
Rochdale Infirmary
Telephone - 01706 517547
Fairfield General Hospital
Telephone - 0161 778 3341
The Royal Oldham Hospital
Telephone - 0161 624 0420
Reference
Date of Review: September 2024
Date of Next Review: September 2026
Ref No: PI_SU_828 (BRO)