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The first clinical application of nitrous oxide (N 2 O) was in 1844, by an American dentist named Horace Wells who used it to control pain during tooth extraction. Since then, N 2 O has shared a 170-year history with modern dental anesthesia. N 2 O, an odorless and colorless gas, is very appealing as a sedative owing to its anxiolytic, analgesic, and amnestic properties, rapid onset and recovery, and, in particular, needle-free application. Numerous studies have reported that N 2 O can be used safely and effectively as a procedural sedation and analgesia (PSA) agent. However, N 2 O can lead to the irreversible inactivation of vitamin B12, which is essential for humans; although rare, this can be fatal in some patients.

Complications caused by nitrous oxide in dental sedation