More than just joy: A qualitative analysis of participant experiences during nitrous oxide sedation.

Nitrous oxide, increasingly used for sedation and pain control rather than general anesthesia, produces highly variable subjective experiences that are not always pleasant. In twenty healthy male volunteers who inhaled 50% nitrous oxide for 20 minutes, qualitative analysis of open-ended responses revealed two overarching themes: the drug is mind-altering and causes sensory overload. Mind-altering effects included dreamlike states—encompassing changes in consciousness and scary, bizarre, or transcendental dreams, but no pleasant dreams—and heightened emotions such as euphoria, anxiety, and fear of losing control. Sensory overload comprised distorted perception, bodily sensations, and a heightened sense of surroundings. These findings help clinicians understand patient likes and dislikes during nitrous oxide sedation.

Study at a glance

Abstract

Nitrous oxide use is shifting from general anesthesia to sedation and pain control. Interest in novel uses of nitrous oxide in psychiatry is also growing. Thus, understanding the consequences of using nitrous oxide remains relevant. Previous quantitative research might not have fully captured the whole spectrum of nitrous oxide, whereas qualitative analysis can provide a more comprehensive description. This qualitative study aims to describe the subjective experiences of nitrous oxide use in healthy volunteers who have no prior history of recreational substance misuse. Twenty healthy male volunteers inhaled 50% nitrous oxide for 20 min. Females were excluded due to higher incidence of nausea with nitrous oxide. Afterwards, all participants answered an open-ended question about their experiences during sedation. The answers were then analyzed with inductive qualitative content analysis to identify emergent subcategories, categories, and overarching themes. We identified two themes: nitrous oxide is mind-altering and produces sensory overload. The mind-altering properties were represented by dreamlike states and heightened emotions. Dreamlike states comprised changes in consciousness and scary, bizarre, or transcendental dreams. Pleasant dreams were not reported. Heightened emotions included euphoria, anxiety, and fear of losing control. Sensory overload consists of distorted perception, bodily sensations, and a heightened sense of surroundings. Experiences under nitrous oxide sedation are extremely variable and not always pleasant. These findings can improve our understanding of the likes/dislikes of patients undergoing nitrous oxide sedation. Further qualitative studies should focus on the experiences of other groups, such as children or women in labor.