What Is Laughing Gas?
Nitrous oxide, commonly known as laughing gas or happy gas, is a colorless, non-flammable gas, with a sweetish odor. It's used in medical and dental procedures as a sedative, relieving anxiety and allowing you to relax before any work is done.
Nitrous oxide was first used as an anesthetic in the 1800s. Nowadays, it's usually combined with oxygen for sedation purposes and is the most-used gas anesthetic in the world.
Outside of medicine, nitrous gas is used for aerosol whipped cream and cooking spray; in automobile racing to make engines to go faster; and as a recreational drug.
Despite the name, laughing gas isn't guaranteed to make you laugh. But it might make you giggle.
Benefits of Nitrous Oxide
There are several reasons doctors and dentists still use nitrous oxide for minor procedures.
Helps relieve anxiety. It calms the patient down and enhances cooperation.
Easy to administer. No needles needed. You're simply given a mask to cover your nose (or nose and mouth) and told to breathe.
Kicks in fast. It starts working in 3-5 minutes.
Short-acting. It's gone 5-10 minutes after your health care provider turns off the gas flow.
Safe for patients. The delivery system has at least 12 audio and visual safety features to prevent any problems while administering the gas.
What Does Laughing Gas Do?
Laughing gas helps you remain calm while your doctor or dentist does their work. The gas is not meant to put you fully to sleep. It doesn't completely stop pain, but it does raise the threshold at which you feel pain. For procedures that might cause a lot of pain, you might need a stronger or extra anesthetic.
Nitrous oxide is a depressant, so it slows your body down. Once it kicks in, you may feel:
- Happy
- Giggly
- Light-headed
- Mild euphoria
- Relaxed
Nitrous oxide gets the name “laughing gas” because of these effects. Some people have mild hallucinations while under its influence.
Before your procedure, your health care provider will ask for your consent to use nitrous oxide. After that, they place a plastic mask will over your nose or mouth and nose. The laughing gas flows through the mask, and you breathe it in.
Children may get laughing gas through a nasal hood, which covers their nose but not their mouth. Sometimes, a familiar scent will be added to help them get used to having the mask or nasal hood on.
You’ll start to feel the effects of the laughing gas within a few minutes. As it doesn’t put you fully to sleep, you’ll still hear what’s going on around you. You should be able to respond to questions that your provider asks you and follow their instructions.
Physically, you might feel like your arms and legs are heavy. You may also have a tingling sensation in your limbs.
Once your procedure is over, your provider will remove the mask that’s providing the nitrous oxide. The effects of laughing gas typically wear off within a few minutes. Children might be given 100% oxygen after the nitrous oxide mask is removed. The oxygen helps them to fully recover within minutes.
Nitrous Oxide Side Effects
Nitrous oxide is safe to use when given by a health care professional. Some people may have side effects either during or after use.
The most common side effects are headaches and nausea. Children may feel agitated or vomit after the laughing gas is removed. The good news is that only about 5% of patients have these side effects.
There are no long-term side effects when nitrous oxide is used now and then. But if you need many procedures that require laughing gas, your might have to take a B12 supplement. Nitrous oxide can inactivate an important enzyme needed to process vitamins B12 and B9 (folate), which could lead to anemia. B12 is also needed for protecting nerves in the brain and spinal cord.
Who Shouldn't Get Nitrous Oxide?
Nitrous oxide isn't for everyone. The following people may need to avoid it:
Very ill patients. In healthy people, the chance of nitrous oxide causing anemia is low, but with critically ill patients, there's a greater risk.
People with heart conditions. Breathing nitrous oxide can cause an amino acid in your blood called homocysteine to rise. High levels of homocysteine have been linked to heart problems, though not for certain. Still, if you have severe heart disease, it's probably wise to not get laughing gas.
Women in their first trimester. During the first 3 months of pregnancy, you shouldn't get laughing gas because it will cause B12 and B9 to not be processed, and both vitamins are essential for your baby's development. But many women use laughing gas during labor to cope with pains.
People having surgeries in closed-air spaces. This includes treatment for pneumothorax (collapsed lung) and small bowel obstruction, middle ear surgery, and retinal (eye) surgeries. Nitrous oxide can rapidly increase gas volume and pressure in these closed spaces to a dangerous level, so it should be avoided for these types of procedures.
People with serious psychiatric disorders. Because nitrous oxide can cause hallucinations, it shouldn't be given to people already having these types of visions.
Children under 3. There's no data showing that laughing gas is unsafe for children. Still, the FDA released a safety alert on the risk of potential harm from repeated use of anesthetic drugs (including nitrous oxide) for children under the age of 3. Also, kids this young may not be able to handle breathing through a mask.
Recreational Use of Nitrous Oxide
Some people misuse nitrous oxide as a recreational drug. It's easy to get hold of because you can buy it legally; for instance, for food purposes. Drug users usually dispense the gas into another object, like a bag or balloon to inhale, or directly into their mouths. Because of this, nitrous oxide is classified as an inhalant. The drug is nicknamed "whippits" or "whippets" because it's often inhaled from the silver chargers used to make whipped cream.
Laughing gas makes users feel euphoric. But since the effect only lasts a few minutes, they have to inhale over and over to keep the high going.
Risks of nitrous oxide
Several risks come with using laughing gas as a recreational drug, including:
- Lowering of blood pressure
- Fainting
- Heart attack
- Hypoxia, or the fatal loss of oxygen
- Not enough B12 and anemia
- Nerve damage due to the tingling sensation
Long-term misuse of nitrous oxide has negative side effects, like:
- Memory loss
- Incontinence
- Depression
- Psychological dependence on the inhalant
- Loss of contact with reality
- Weak immune system
- Numbness in your hands and feet
- Limb spasms
- Ringing in your ears
- Vitamin B12 depletion
- Possible birth defects (if used during pregnancy)
Another risk of abusing laughing gas is that it affects your coordination. This can be dangerous if you're inhaling nitrous oxide in a place where you could fall and hurt yourself or others. You shouldn't try to drive or operate machinery while under the effects of laughing gas.
Can you get addicted to laughing gas?
Laughing gas isn't physically addictive, in the sense that it doesn't affect hormones such as dopamine and alter brain chemistry in the way cocaine does. But you can develop a psychological dependence on nitrous oxide.
When the gas is used medically, it's mixed with oxygen at a 30:70 ratio, so most of what you take in is oxygen. But whippets are 100% laughing gas. Breathing this in decreases oxygen and increases carbon dioxide in your lungs, creating that lightheaded high. But long-term, you might suffer hypoxia.
Takeaways
Laughing gas (nitrous oxide) is an anesthetic used by doctors and dentists to help you remain calm before a procedure. It’s not meant to put you fully to sleep, but to have you relax. It can make you feel happy, light-headed and euphoric. But the effects only last a few minutes after the gas flow is turned off, so you don't have lasting side effects when it's used medically. Some people use the gas to get high, which can cause many health problems if used for a long time.
Laughing Gas FAQs
How long does laughing gas last?
The effects last about 5-10 minutes after you stop inhaling it.
Is laughing gas safe for kids?
Yes. The American Academy of Pediatric Dentistry finds it safe and effective for children, as does a 2008 study published in Pediatrics, the official journal of the American Academy of Pediatrics (AAP). The only caution might be age. Pediatrics reported that laughing gas seemed safe for children 1 to 3 years old, but in 2016, the FDA warned that "repeated or lengthy use" of sedation drugs in children under 3 may affect the development of children's brains. The AAP and several other medical groups noted that studies didn't show any developmental problems from one short dose of sedation and that there's also a risk with delaying needed surgery until a child is older.
How aware are you when you use laughing gas?
While you should feel relaxed, you'll still be able to respond to questions or instructions from your dentist or doctor. You're not completely "out."
Can you eat before laughing gas?
You can, but since nitrous oxide has a possible side effect of nausea, it's best not to eat too much. Eat a light meal an hour or two before your procedure.