Nitrous Oxide (Laughing Gas)

What is nitrous oxide (laughing gas)?

Nitrous oxide (N20) — commonly known as laughing gas — is a type of short-acting sedative. It’s a colorless, slightly sweet-smelling gas that you breathe in through a mask or nosepiece.

Physicians and dentists have been using nitrous oxide since the mid-19th century — and it’s still one of the most common inhaled sedatives used today. It’s fast-acting and it wears off quickly, making it an ideal sedation option for short or minor procedures.

What does laughing gas do?

Nitrous oxide slows down your nervous system and induces a sense of calm and euphoria. It reduces anxiety and helps you stay comfortable during medical or dental procedures. It doesn’t fully put you to sleep, so you’ll still be able to respond to your provider’s questions or instructions.

Despite its name, laughing gas might not make you laugh. (But then again, it could.) Everyone responds a little differently.

Nitrous oxide takes effect quickly. Within three to five minutes, you might feel:

• Calm.
• Relaxed.
• Happy.
• Giggly.
• Mildly euphoric.
• Light-headed.
• Tingling in your arms and legs.
• Heaviness, like you’re sinking deeper into the exam chair or table.

Who shouldn’t use nitrous oxide sedation?

Laughing gas is a safe medical and dental sedation option for most people, from children to adults. But it might not be right for kids under the age of 2 and those with:

• Certain respiratory conditions, like chronic obstructive pulmonary disease (COPD).
• Stuffy nose (nasal congestion).
• Vitamin B12 deficiency.
• Severe psychiatric conditions.

Ask your healthcare provider whether you’re a candidate for nitrous oxide sedation.

What should I expect if I’m getting laughing gas?

Your healthcare provider will talk with you and answer any questions before your procedure. They’ll ask you to sign a consent form so you can receive nitrous oxide.

When it’s time for your procedure, your provider will:

• Place a mask over your nose and mouth. (If you’re getting laughing gas at your dentist’s office, they’ll give you a smaller mask that only covers your nose.)
• Open a tank valve to allow nitrous oxide and oxygen to flow into your mask. (They’ll start with a very low dose to see how you respond.)
• Adjust the dosage until you feel the desired effects.
• Do your procedure. (In many cases, your provider will also give you local anesthesia before beginning. This is because nitrous oxide reduces pain but won’t totally eliminate it. So, it’s common to combine it with other forms of anesthesia.)
• Stop the flow of laughing gas once your procedure is over.
• Ask you to breathe in pure oxygen through your mask until you feel alert again.
• Remove the mask from your face.
• Monitor you for a few minutes before releasing you to go home.

It’s normal to feel a little nervous if you’ve never had laughing gas before. The good news is that you’ll be able to tell your provider if you develop undesirable side effects. If you start to feel dizzy or nauseous, your provider can simply adjust the dosage until it feels comfortable to you.

How long does laughing gas last?

The effects of nitrous oxide last until your provider turns off the gas flow. Once this happens, it takes about 5 to 10 minutes for the sedative to leave your system and for your headspace to return to normal. Due to the short-acting nature of nitrous oxide, you can drive shortly after your procedure.

What are the benefits of nitrous oxide?

The most notable advantage of laughing gas is that it relieves anxiety. People with medical- or dental-related fears often avoid healthcare visits and put off necessary procedures. Nitrous oxide makes it possible for people to get the care they need and deserve.

Nitrous oxide is also:

• Fast-acting (the effects kick in quickly).
• Short-acting. (Once your provider turns off the gas flow, you’ll start feeling like your usual self in a matter of minutes. This can be helpful if you find the effects of nitrous oxide unpleasant.)
• Easy to administer and doesn’t require needles.
• Safe and effective when given in a healthcare setting.

What are the possible complications of nitrous oxide in a dental or medical setting?

Laughing gas doesn’t cause any long-term complications when given under the care of a healthcare provider. But frequent nitrous oxide exposure (for multiple-phase dental treatment, for instance) can result in vitamin B12 deficiency. If you’re planning several appointments with laughing gas, ask your provider whether you should take a vitamin B12 supplement.

Some people may develop temporary nitrous oxide side effects like:

• Headaches.
• Nausea and vomiting.
• Agitation.

These side effects go away once the nitrous oxide leaves your system.

What are the risks of using nitrous oxide recreationally?

Some people use nitrous oxide recreationally to achieve a momentary euphoric high. But inhaling laughing gas more often than you need it can cause serious and potentially life-threatening health complications like:

• Low blood pressure (hypotension).
• Low oxygen (hypoxia).
• Fainting.
• Heart attack.
• Nerve damage.

People who use laughing gas recreationally have an increased risk of these long-term health conditions:

• Depression.
• Psychosis.
• Memory loss.
• Muscle spasms.
• Tinnitus (ringing in your ears).
• Numbness, especially in your hands and feet.
• Weakened immune system.
• Birth defects (if used during pregnancy).

When should I call my healthcare provider?

If nitrous oxide side effects like headaches and nausea occur, they usually happen before you leave your appointment. Your healthcare provider can manage any side effects with oxygen and pain relivers or anti-nausea medications.

When younger kids receive laughing gas, it can be difficult to know exactly how they’re feeling. If your child received nitrous oxide sedation and develops nausea or vomiting after you leave the office, call your provider for further instructions. They can tell you how to manage the side effects and make your child comfortable. (To reduce the risk of nausea in children and adults, eat a light meal an hour or two before your appointment. A full belly might make you sick to your stomach.)

Can you still feel pain with laughing gas?

Laughing gas dulls your sensitivity to pain, but it doesn’t eliminate it. Most healthcare providers use laughing gas in combination with local anesthesia for optimal comfort.

Is nitrous oxide good or bad for you?

As with any medication or sedative, moderation is key. When given under the care of a healthcare provider, laughing gas safely and effectively reduces anxiety during procedures.

But if you take too much nitrous oxide — or use it recreationally — you increase your risk of serious and life-threatening complications, including loss of consciousness and suffocation (asphyxiation).

Can you use nitrous oxide during labor?

Many pregnant people benefit from using laughing gas during labor and delivery. Nitrous oxide is a good option for people who want pain relief they can control.

A provider adjusts the dosage accordingly throughout labor and delivery. Some people prefer to use laughing gas during contractions, while others use it to relax during the time between them. Ask your obstetrician if nitrous oxide sedation is right for you.

A note from Cleveland Clinic

If you’ve been putting off medical or dental appointments, you’re not alone. Chances are, you don’t love the thought of white-knuckling it through your procedure, no matter how “simple” your provider says it’ll be. You don’t have to live with healthcare-related anxiety. When used properly, nitrous oxide is one of the safest, most effective short-acting sedatives available. Ask your healthcare provider if it’s an option for you.