Using Dental Nitrous Carts in Aesthetic Procedures

Portable nitrous delivery systems have traditionally been used in dental offices to perform conscious sedation procedures on patients, however more and more physicians in the aesthetics industry are discovering their ability to help with patient pain management during aesthetic procedures. Portable nitrous flowmeter carts are able to provide a mixture of nitrous oxide and oxygen to patients, which helps alleviate any pain or discomfort associated during these in-office procedures. Some of the procedures nitrous delivery systems are being used for include botox injections, laser hair removal, laser tattoo removal, and dermal filler injections. Since the system is mobile, it also allows offices more flexibility as they are able to move the cart from room to room without having to have a costly gas pipeline installation for their facility. 

How do they work?

The nitrous carts come with a flowmeter that is able to control the flow of oxygen and nitrous independently. This flowmeter can be either analog or digital depending on preference. The flowmeters are able to deliver a gas mixture of up to 70% nitrous and 30% oxygen. The flow rate is controlled using the dial or buttons on the front of the flowmeter. Typical flow rates are 0-7 LPM for nitrous and 3-10 LPM for oxygen. The carts come with a yoke block that attaches to the mobile stand and holds four E-cylinders (two for oxygen and two for nitrous oxide). You can use the cart with just two tanks (one oxygen and one nitrous) but this is not recommended for patient safety in the event the tanks run out of gas during a procedure. The scavenging unit that comes with many of these carts includes a reusable nasal hood that goes over the patient’s nose to breathe in the gas, however a full face mask is recommended whenever possible as this delivers a more accurate gas flow during procedures. A mouthpiece is also available as an option for patient gas delivery. Many of the scavenging units are reusable and can be easily sterilized between patients, however disposable scavenging units are also available. 

Popular Nitrous Carts

There are three manufacturers of portable nitrous carts: Belmed, Accutron, and Porter. Each of these units are made by reputable manufacturers and come with standard 2 year warranties. 

• Belmed F300 – The Belmed Flowmeter F300 comes with an analog flow meter that is controlled using the knobs/dials on the front of the flowmeter head. At the moment, Belmed only produces analog units. These analog units are very reliable, durable, and easier to use than digital systems. Another advantage to the Belmed portable nitrous cart is the price. The F300 is about $1,000 less on average than the Accutron or Porter analog system making it the perfect solution for many facilities. 

• Accutron & Porter Nitrous Systems – Similar to Belmed, both Accutron and Porter make high quality, reliable and durable products. Their analog flowmeters are also easy to use and controlled via knobs/dials. Both Porter and Accutron also produce digital nitrous flowmeters. Accutron’s product line is more diverse than Porter’s when it comes to nitrous cart packages, but both manufacturers currently have extended lead times of 16 weeks or more as of 11/27/2020. If you are needing a portable nitrous system sooner rather than later, and can use an analog system, then Belmed would be the best option as their lead is only 4-6 weeks as of 11/27/2020. 

Importance of Scavenging

It is important to note that anytime a nitrous gas is being used, there should be an appropriate scavenging system in place to remove the excess nitrous oxide gas from the area and take appropriate measures to prevent unnecessary exposure. While many facilities have WAGD outlets that can connect to the hose and vacuum out the excess nitrous, there are many facilities that do not have these medical gas outlets in place. Letting excess nitrous gas free float is not recommended. The CDC has reported that long-term exposure to nitrous gas during procedures can lead to serious medical conditions such as infertility, miscarriages, and even an increased risk of neurologic, renal and liver disease. For facilities that do not have WAGD outlets available, it is recommended that the excess gas be let out through a window or that a portable scavenging system, such as the MINISCAV®, be used.