Nitrous oxide (Kalinox) is a gas the patient breathes rather than a drug given by injection. Nitrous oxide in moderate sedation is titrated breath to breath by adjusting the delivered concentration, which is why both onset and offset are fast compared with the injectable agents on this site.
Dosage and Effect
Initial dose: Titrate to effect
Onset of action: 2-3 minutes
Peak effect: Dose dependent
Duration of effect: 15-30 minutes
Reversal Agent:
None
Nitrous Oxide in Moderate Sedation
Nitrous oxide is typically the lightest layer of moderate sedation — an anxiolytic and mild analgesic delivered through a nasal hood or mask, blended with oxygen at a minimum 30% concentration. Because the patient breathes it in and out, depth can be adjusted up or down within a minute or two, and it clears on its own once the mask comes off and the patient breathes room air or 100% oxygen for a few minutes. It depends on the patient keeping a seal on the mask and breathing cooperatively, so it is not a fit for anyone who cannot tolerate the delivery device or follow simple instructions. Standard monitoring — pulse oximetry and patient responsiveness — continues throughout, and the delivery room should have scavenging in place to limit staff exposure. Who may administer it is set by facility policy and the state’s scope-of-practice rules for the credential doing the delivering.
Educational reference for sedation providers, relocated from the previous version of this site — not a substitute for the current package insert, your facility protocols, or clinical judgment. Verify all doses against current references before clinical use.