Nitrous Oxide

Nitrous Oxide is available in the following forms:

• Gas For Inhalation

Nitrous Oxide,
REFREGERATED LIQUID
USP

UN2201

NON-FLAMMABLE GAS 2 OXIDIZER 5.1

DANGER: CONTAINS GAS UNDER PRESSURE: MAY EXPLODE IF HEATED. MAY DISPLACE OXYGEN AND CAUSE RAPID SUFFICATION. MAY CAUSE OR INTENSIFY FIRE: OXIDIZER. CONTAINS REFRIGERATED GAS: MAY CAUSE CRYOGENIC BURNS OR INJURY. MAY CAUSE DROWSINESS OR DIZZINESS.

Do not breathe gas. Do not get into eyes, on skin, or on clothing. Keep valves and fittings free from grease and oil. Use and store only outdoors or in a well ventilated place. Avoid spills. Do not walk or roll equipment over spills. Open valve slowly. Close valve after each use and when empty. Use a back flow preventive device in the piping. Do not handle until all safety precautions have been read and understood. Wear cold insulating gloves/face shield/eye protection. Do not drop. Use a suitable hand truck for container movement. Always keep container in upright position. DO NOT change or force fit connections. Use only with equipment cleaned for oxygen service. Keep/store away from clothing and other combustible materials. In case of fire: Stop leak if safe to do so. Store locked up. Read and follow the Safety Data Sheet (SDS) before use.

FIRST AID: IF INHALED: Remove to fresh air and keep comfortable for breathing. Get medical advice/attention. IF ON SKIN: Thaw frosted parts with lukewarm water. Do not rub affected area. Call a POISON CENTER or doctor/physician if feeling unwell.

RX Only

WARNING: Administration of Nitrous Oxide may be hazardous or contraindicated. For use only by or under the supervision of a licensed practitioner who is experienced in the use and administration of Nitrous Oxide and is familiar with the indications, effects, dosages, methods, and frequency and duration of administration, and with the hazards, contraindications and side effects, and precautions to be taken.
CAS: 10024-97-2

WARNING: This product contains a chemical known to the state of California to cause birth defects or other reproductive harm.

DO NOT REMOVE THIS PRODUCT LABEL

AIRGAS® Healthcare
an Air Liquide Company
AIRGAS USA, LLC
Radnor, PA 19087-5283

Safety Data Sheets available at www.airgas.com

844066 (06/16)

Nitrous Oxide,
USP
UN1070

NON-FLAMMABLE GAS 2 OXIDIZER 5.1

Rx only.

WARNING: Administration of Nitrous Oxide may be hazardous or contraindicated. For use only by or under the supervision of a licensed practitioner who is experienced in the use and administration of Nitrous Oxide and is familiar with the indications, effects, dosages, methods, and frequency and duration of administration, and with the hazards, contraindications and side effects and precautions to be taken.

DANGER: CONTAINS GAS UNDER PRESSURE: MAY EXPLODE IF HEATED. MAY DISPLACE OXYGEN AND CAUSE RAPID SUFFICATION. MAY CAUSE OR INTENSIFY FIRE: OXIDIZER. MAY CAUSE FROSTBITE. MAY CAUSE DROWSINESS OR DIZZINESS.

Do not breathe gas. Do not get into eyes, on skin, or on clothing. Keep valves and fittings free from grease and oil. Use and store only outdoors or in a well ventilated place. Protect from sunlight when the ambient temperature exceeds 52°C/125°F. Open valve slowly. Close valve after each use and when empty. Use a back flow preventive device in the piping. Do not handle until all safety precautions have been read and understood. Use only with equipment of compatible materials of construction and rated for cylinder pressure. Use only with equipment cleaned for oxygen service. Keep/store away from clothing and other combustible materials. In case of fire: Stop leak if safe to do so. Store locked up. Read and follow the Safety Data Sheet (SDS) before use. FIRST AID: IF INHALED: Remove to fresh air and keep comfortable for breathing. Call a POISON CENTER or doctor/physician if feeling unwell. IF ON SKIN: Thaw frosted parts with lukewarm water. Do not rub affected area. Get immediate medical advice/attention. WARNING: This product contains a chemical known to the state of California to cause birth defects or other reproductive harm.

DO NOT REMOVE THIS PRODUCT LABEL

Form 850400 (R 06/16)

AIRGAS® Healthcare
an Air Liquide Company
AIRGAS USA, LLC
Radnor, PA 19087-5283

Safety Data Sheets available at www.airgas.com

Summary of Use during Lactation

Because the serum half-life of nitrous oxide in the mother is short and the drug is not expected to be absorbed by the infant, no waiting period or discarding of milk is required.[1][2] Some evidence indicates that primiparous mothers who use inhaled nitrous oxide during labor for analgesia have better breastfeeding success than mothers who do not. If used as part of general anesthesia, breastfeeding can be resumed as soon as the mother has recovered sufficiently from anesthesia to nurse. When a combination of anesthetic agents is used for a procedure, follow the recommendations for the most problematic medication used during the procedure.

Drug Levels

The serum half-life of nitrous oxide is less than 3 minutes, so extensive passage into milk is unlikely.[1]

Maternal Levels. Relevant published information was not found as of the revision date.

Infant Levels. Relevant published information was not found as of the revision date.

Effects in Breastfed Infants

Relevant published information was not found as of the revision date.

Effects on Lactation and Breastmilk

A randomized, but nonblinded, study in women undergoing cesarean section compared epidural anesthesia with bupivacaine to general anesthesia with intravenous thiopental 4 mg/kg and succinylcholine 1.5 mg/kg for induction followed by nitrous oxide and isoflurane. The time to the first breastfeed was significantly shorter (107 vs 228 minutes) with the epidural anesthesia than with general anesthesia. This difference was probably caused by the anesthesia's effects on the infant, because the Apgar and neurologic and adaptive scores were significantly lower in the general anesthesia group of infants. It is not known what part nitrous oxide played in this difference in outcome.[3]

A retrospective database study found that primiparous women who receive a nitrous oxide-oxygen mixture for pain during delivery in addition to routine analgesia were more likely to be breastfeeding their infants at 48 hours postpartum than women who did not receive nitrous oxide. This correlation was not found when all women were included in the analysis.[4]

In a nonrandomized, nonblinded retrospective study, 62 women who chose labor with gas analgesia with 50% nitrous oxide and oxygen were compared to a control group of 124 women who did not receive gas analgesia during labor. Most of the women in the study were primiparous. Use of other labor medications was not reported. Women who received nitrous oxide had higher rates of breastfeeding than those who did not at 7 days after discharge (100% vs 93%), at 1 month postpartum (93% vs 82%), and at 3 months postpartum (86% vs 70%).[5]

References

1. Hale TW. Anesthetic medications in breastfeeding mothers. J Hum Lact. 1999;15:185-94. PMID: 10578796

2. Rooks JP. Safety and risks of nitrous oxide labor analgesia: a review. J Midwifery Womens Health. 2011;56:557-65. PMID: 22060215

3. Sener EB, Guldogus N, Karakaya D et al. Comparison of neonatal effects of epidural and general anesthesia for cesarean section. Gynecol Obstet Investig. 2003;55:41-55. PMID: 12624551

4. Jordan S, Emery S, Watkins A et al. Associations of drugs routinely given in labour with breastfeeding at 48 hours: Analysis of the Cardiff births survey. BJOG. 2009;116:1622-32. PMID: 19735379

5. Zanardo V, Volpe F, Parotto M et al. Nitrous oxide labor analgesia and pain relief memory in breastfeeding women. J Matern Fetal Neonatal Med. 2017;1-22. PMID: 28814150

Substance Name

Nitrous Oxide

CAS Registry Number

10024-97-2

Drug Class

Anesthetics, Inhalation