Nitrous oxide as an adjunct in tumescent liposuction.

Background: Nitrous oxide (N(2)O) has been used as an anesthetic for over 300 years. It is safe, easy to use, and effective. In this article we will document N(2)O use as an adjunct to tumescent liposuction. The history, mechanism of action, use, and safety in ambulatory surgery of N(2)O are reviewed.

Objective: The authors intend to review the history of both tumescent liposuction and N(2)O in surgery, discuss the possible adverse reactions, and present guidelines for the use of N(2)O during tumescent liposuction.

Methods: A Medline review of articles, 1966-2004, related to N(2)O was performed, using the search terms nitrous, oxide, safety, toxicity, mechanism, anesthetic, surgery, risks, and delivery. Articles that were cited by the authors of this subset of original articles were also used when appropriate. Articles were rated and included based on date of publication, level of evidence, and applicability to tumescent liposuction.

Results And Conclusions: Nitrous oxide is safe, easily administered, inexpensive, and is an effective adjunct to tumescent liposuction. It provides a high level of pain control, and is patient controlled, while not putting the patient at risk of full anesthesia. When used correctly, with proper equipment, it poses little risk to either patients or healthcare workers.