Tools of the trade: Porter MXR 3000 Flowmeter

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flowmeterby Dr Shreyas Suryanarayana, Lynbrook Dental Care, VIC

While we use an anaesthetist to provide a higher level of sedation for our patients, the Porter mixer allows us to administer nitrous oxide sedation ourselves. Generally, we use it with anxious patients who have had trouble with dentistry in the past and with very young children who need complex treatments.

What’s good about it

Nitrous oxide is completely reversible. While being breathed in, it’s very effective but once the gas is stopped, it’s expelled from the lungs and no longer in the patient’s system.

This mixer allows us to administer the correct amount of nitrous oxide by titrating to effect. The mixer also has a built-in safety feature that doesn’t allow less than 30 per cent oxygen in the mix. Every patient requires a different concentration of nitrous and that amount can change from visit to visit. It all depends on the anxiety level of the patient on that day. We titrate to effect in small increments and sit at that increment for at least three minutes in order to stabilise.

Patients recover from the effects of nitrous very quickly. While there can be dizziness and nausea in rare cases, most people are perfectly fine in a very short amount of time. We usually finish a session with a 100 per cent oxygen flush for the last five minutes. Patients are fine to drive home after their procedure.

Patient response has been very positive with many saying they couldn’t imagine a dental procedure without using nitrous. It’s a great tool provided it’s used safely.

What’s not so good

The only negative is the time required in the use of nitrous sedation. When titrating to effect, the process can’t be rushed. You have to wait three to five minutes at every level. This is not a criticism of the Porter system; it’s simply the way this type of sedation works.

 

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