{"id":20122,"date":"2021-06-25T12:13:05","date_gmt":"2021-06-25T19:13:05","guid":{"rendered":"https://www.realself.com\/news\/?p=20122"},"modified":"2024-02-16T09:50:19","modified_gmt":"2024-02-16T17:50:19","slug":"pro-nox-pros-and-cons","status":"publish","type":"post","link":"https://www.realself.com\/news\/pro-nox-pros-and-cons","title":{"rendered":"The Rise of Pro-Nox in Aesthetics: Doctors Weigh In on the Pros and Cons of Laughing Gas"},"content":{"rendered":"

Known for inducing fleeting bouts of euphoria, nitrous oxide (N2O), or laughing gas, boasts a storied history<\/a> as a party drug—and according to a rep<\/a>o<\/a>rt<\/a> in The<\/em> New York Times<\/em>, the inhalant has recently staged a pandemic-fueled comeback, despite numerous studies<\/a> linking its chronic misuse to myriad neurological issues. In the medical field, of course, nitrous has long been prescribed, in controlled doses, to make everything from dental work to childbirth more bearable. <\/p>

Over the past few years, nitrous oxide has seeped into the aesthetics realm, helping to take the edge off energy-based procedures and injectable treatments. When used in dermatology and plastic surgery, the gas is generally blended with oxygen and self-administered through a mouthpiece that requires patients to actively breathe in the mixture, via a system like Pro-Nox<\/a>, which is found in thousands of practices across the country. (In cosmetic medicine, Pro-Nox has essentially become synonymous with laughing gas.)<\/p>

As nitrous use grows in aesthetics, some doctors are raising concerns about the gas and the potential risks it poses—to both patients and the planet. Ahead, we take a closer look at the analgesic, its role in cosmetic medicine, and the questions surrounding its safety.<\/p>

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What is Pro-Nox, and how does it work?<\/h2>

Pro-Nox is a proprietary, patient-controlled system that delivers nitrous oxide and oxygen, in a fixed 50\/50 ratio. According to Dr. Azza Halim<\/a>, a board-certified anesthesiologist in Boca Raton, Florida, Pro-Nox targets the central nervous system, “acting on the GABA receptors and pain centers in the brain and spinal cord,” to ease discomfort and stress without altering consciousness. (In comparison, the nitrous oxide in dentists’ offices is typically a higher concentration, around 70%, “and can render sedation and loss of consciousness,” she says.) The effects of Pro-Nox are said to dissipate completely within five to seven minutes. (To be safe, providers usually have patients wait 10–15 minutes post-procedure before driving home.)  <\/p>

“Nitrous oxide is not truly metabolized, as some think,” adds Dr. Halim, noting that less than 0.004% is actually metabolized by humans. Rather, “it is exchanged through the lungs after diffusion and then exhaled, unchanged<\/a>, into the atmosphere.”<\/p>

Marcel Besse, the executive director for Pro-Nox’s aesthetics division, points out that “Pro-Nox is classified as an analgesic device and not anesthesia” by the U.S. Food and Drug Administration—an important distinction. “Traditionally, analgesia is pain relief without loss of consciousness and without total loss of feeling or movement,” explains Dr. Paul Goehner<\/a>, a board-certified anesthesiologist in Palo Alto, California. “Anesthesia, on the other hand, [causes] the loss of physical sensation, with or without loss of consciousness.” Testifying to the benefits of nitrous oxide in general, he adds, “I’ve utilized nitrous for over 35 years and find it to be a very helpful adjunct.”<\/p>

Unlike conventional nitrous oxide delivery systems, which release a steady stream of gas, Pro-Nox features what the company calls an “on-demand mouthpiece,” which lets patients regulate the amount of gas they consume. “The only time the N2O is flowing is when the patient has the mouthpiece securely in their mouth and is inhaling deeply,” Besse explains. This is thought to make the device safer, by obviating the risk of overdose while potentially improving the overall treatment experience. “Imagine you could control, by your breathing, the level of your sedation,” Dr. Goehner says. “The system requires the patient to interact to receive the gas. Once they’re comfortable, they can simply stop using it.”<\/p>

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A post shared by Juliya Fisher, MD FAAD (@drjuliyafisher)<\/a><\/p><\/div><\/blockquote>