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Sedation Gynecology


Dr. Marvel and the Center for Pelvic Pain at Annapolis now offering sedation gynecologic procedures using the Nitronox™ analgesia system as a way to effectively manage pain and relieve any anxiety you may feel before and during gynecologic exams and procedures.

What is Nitronox™ ?

This pain-managing medication is a combination of two different gasses: nitrous oxide and oxygen. You’re probably already familiar with nitrous oxide, which is also called laughing gas. Dentists and other health care providers use nitrous oxide to help patients relax and stay comfortable during all kinds of minor, minimally invasive or noninvasive procedures. When combined with oxygen, nitrous oxide helps manage pain and anxiety while allowing you to stay awake and aware.  This will allow office procedures such as office hysteroscopy, IUD placements, vulvar or cervical biopsies and nerve blocks to be accomplished with the least amount of discomfort possible.

How Does It Manage Pain During Your Procedure?

Nitronox™ isn’t general or local anesthesia; it’s a relaxant that helps you stay calm during your procedure.  The system uses a face mask or breathing mouthpiece to deliver the mixture of nitrous oxide and oxygen to you during exams or procedures. When using this system, you remain awake during your procedure and are able to respond to your doctor and follow any instructions given to you. Because the system features on-demand delivery, you only receive a dose of nitrous oxide when you breathe in through the mask or mouthpiece. Many people enjoy this self-administration feature because it allows them to control exactly how much pain medication they receive.  This ensures that you have the right amount of anxiety reduction to keep you relaxed, comfortable, and pain-free throughout your treatment.

How Long Do the Effects Last?

It’s important to be able to get back to your normal routine as quickly as possible after an office procedure, and that’s what makes the Nitronox™ system such a good choice for managing pain and anxiety. Unlike other pain medications, your body doesn’t alter or change the nitrous oxide compound after it enters your bloodstream. As a result, the nitrous oxide is quickly and easily exhaled through your lungs. The effects wear off within minutes after you stop using the system.  It is completely eliminated from your system in 5-10 minutes. This helps you get back to your life quickly and without further disruption.

Nitrous oxide has been as a safe, effective analgesic for more than 100 years, and it’s helped people around the world get through minor medical procedures in greater comfort. If you think the Nitronox™ system can help with your pain and anxiety during your gynecologic procedure that you need, make an appointment with Dr. Marvel today.

How will I feel when using nitrous oxide?

Some women report feeling drowsy, light-headed, nauseous, or a little silly while using nitrous oxide. Due to some of these possible side effects, a member of our team will always be in the room while you are using nitrous oxide. These side effects should go away quickly when you stop breathing the nitrous oxide.  If you do not find nitrous oxide helpful or do not like the way that is makes them feel. The use of nitrous oxide can be stopped at any time, and alternative pain management methods can be used.

Does it have any side effects?

Some women have reported nausea after a prolonged use of the gas; medication to help ease the nausea is available if that happens. It can also cause some unsteadiness when standing up. A member of our team will always be in the room when you are ready to stand, in case you need assistance.

Are there any reasons I could not use nitrous oxide?

Yes, you cannot use nitrous oxide if you:

  • Cannot hold your own facemask
  • Have a known vitamin B12 deficiency
  • Are currently pregnant
  • Have received a narcotic medication within the past 2 hours
  • Have other medical conditions identified by your provider that place you at risk

When can Nitronox™ be used to help pain and anxiety in the office?

  • This approach is available any time a patient requests
  • No special appointment is needed
  • No labs or testing is required prior to using Nitronox
  • It can be used for most office procedures including but not limited to IUD insertion, IUD removal, office hysteroscopy, vaginal probe ultrasound, endometrial biopsy, colposcopy, cervical or vulvar biopsies
  • It can be used for patients who have significant fear of pain or a prior history making gynecologic exams difficult or stressful

There is a small fee required to cover the cost of the disposable items used and the cost of gasses.  This is not covered by insurance.

If you are interested about scheduling an exam or office procedure such as IUD placement using nitronox, call the office today at 410-573-1436.