Why is Nitrous Oxide (N2O) not used alone as a general anaesthetic agent?

Nitrous oxide is not used alone as a general anesthetic agent primarily due to difficulties in maintaining an adequate oxygen concentration. While nitrous oxide can provide some analgesic effects and is often used as a sedative in combination with other agents, it does not provide sufficient depth of anesthesia when used by itself. This can result in inadequate oxygen supply to the patient, which is critical for safe anesthetic management. Maintaining proper oxygenation is essential during surgical procedures to prevent hypoxia and ensure patient safety.

In contrast, nitrous oxide has relatively minimal adverse effects on the liver or other organ systems when used appropriately, and its cost is lower than many alternative anesthetics. Moreover, while nitrous oxide does have some analgesic properties, it is not sufficiently effective on its own to replace stronger anesthetic agents required for more invasive procedures. Therefore, its use is typically as an adjunct to more potent anesthetics, which together improve safety and efficacy during anesthesia.