DarmanoX (Entonox)

In the name of God who creates, supply pain and treatment. It is obvious that pain reducing of patients is valuable. All knows that medical team from doctor to nurse consider this point as one of their major duties. Surely, the preferred method of analgesia is affective, low cost and easy available while on the other hand causing less complications and low-risk for both; patient and medical team.
In this way "MIXING OF MEDICAL GASES (50%N2O+50%O2)" Entonox is well-know as one of the choices which is presented to decrease the acute pain.

Research history of "MIXING OF MEDICAL GASES Entonox" in IRAN

The first step of this research was made in 1996. In order to gain the required technical knowledge of this production; and getting familiar to supply the mentioned gas, a team including 4 anesthetist, have been sent to UK from Iranian medical universities by Darmangaz Company.
Simultaneously, in order to have primary trainings and clinical tests, some of the "MIXING OF MEDICAL GASES Entonox" cylinders had imported to IRAN with health embassy allowance and were supplied by the Iranian medical universities. On July 1997 after getting the confirmation of the mentioned universities, license production of the "MIXING OF MEDICAL GASES Entonox" were issued by health embassy.
Finally with great attempt of our managers and specialists, this company could satisfy to produce the gas in a great amount and received the exploitation license from health embassy. This company honors to be as fair performer and trains workshops in medical universities of "Isfahan, Ahvaz, Ourumieh, Tabriz, Tehran, Shiraz, kermanshah, Hamadan, Yazd, Yasoj, Mashhad, Rasht and Rafsanjan. Now in many cities such as Zahedan, Karaj, Arak, Bushehr, Kerman, Gonbad-e-kawus, Isfahan, Ahvaz, Ourumieh, Tabriz, Tehran, Shiraz, kermanshah, Hamadan, "MIXING OF MEDICAL GASES Entonox" is using for acute pain management specially in labor pain.

Introduction of "MIXING OF MEDICAL GASES Entonox"

MIXING OF MEDICAL GASES Entonox is a homogenous, equal mixture of oxygen and nitrous oxide (50%/50%) in one cylinder. Although nitrous oxide was discovered as an analgesic gas for more than 2 centuries and is used, but because of hypoxemia as its complication in 1965, it is used plus oxygen with the commercial name of analgesic gas "MIXING OF MEDICAL GASES Entonox" that come from chemical names of them.
Getting familiar with "MIXING OF MEDICAL GASES Entonox" and its specifications caused it as a common standard analgesic in emergency centers and even ambulances. Frankly it can be said that up to now, analgesic gas is used more than 35 years in treatment of patients and has been one of the successful ways of treatment as analgesic agent. The analgesic gas production technology now is available in our country and we hope to prompting help the painstaking patients by getting more familiar with this drug from doctor, nurse or midwife and support of related responsible.

Analgesic gas effect mechanism

After inhalation, N2O is entered the circulation "about 15 seconds after use" and because of low blood solubility, the suitable concentration and desirable partial pressure reach to the brain and spinal cord to be effective by suppressing the brain centers and increasing endorphins, produces analgesia, sedation, apathy about the environment and to some extent euphoria. These effects start within 30 seconds and reach the maximum at 2 minutes.


This gas can be used in all type of acute pains occurred in a limited period of time provided that there is no contraindication. Generally, it is used successfully in the following cases:
1- Myocardial infarction
2- Change dressing and discharge drains
3- Suturing the wound
4- Remove the sutures in sensitive and painful area
5- Dressing and debridement in burned patients
6- Aggressive procedures such as urinary catheterization in male
7- Constipation
8- Painful changing position
9- Painful injection especially in pediatrics
10- Pain in trauma
11- Pain in dentistry
12- Painful Physiotherapy
13- Postoperative pain
14- Renal colic
15- Sternal bone biopsy
16- Changing position, manipulation and splint of suffered limb
17- Pining and ex-pining of bone
Labor pain is one of the most painful one which always human being have been faced to. The man has had last long wish to be able for controlling labor pain which always has been as an untouchable dream. Analgesic gas "MIXING OF MEDICAL GASES Entonox" is a simple way with an acceptable effect which can be supplied in all regions even with the least medical equipments. MIXING OF MEDICAL GASES Entonox administers at commence of active phase, also it is valuable to use for second stage of labor, of course it is better to give oxygen supplement to newborn for first 10 minutes of life. MIXING OF MEDICAL GASES Entonox have special concern in labor analgesia because of it has acceptable effect, ease of use and supply, and without any serious complications. Indeed, in UK home delivery is performed safety by MIXING OF MEDICAL GASES Entonox.

Special advantages

1- Desirable analgesic effect
2- Fast onset
3- Fast offset
4- Use with Self-Administration Patient Control Anesthesia
5- Have no limited dose
6- Have no over dose
7- Have no residual and additional effects in repeated dose
8- Prescribe directly by trained and experienced personal
9- Have no suppressing effect on cardiovascular & respiratory
10- Have good tissue oxygenation because of high O2 percent (50%) of it
11- Taking good patient cooperation due to close communication during administration
12- Direct patient participation in pain alleviation yields more acceptance and confidents to medical therapy
13- It is suitable replace for opioids in pediatrics that limit their use for fearing of opioid complication


1- Loss of consciousness ( head trauma) 2- Poisonings 3- Face and cheek trauma 4- Any where that closed air increments is dangerous such as air emboli, pneumothorax, bullous emphysema, pneumocephaly 5- Decompression sickness or a recent dive 6- Abdominal distention due to bowel obstruction

How to prescribe

It is known as specific cylinders with blue color in body and white and blue in collar in various sizes presented to be prescribed with a Self-Administered analgesia for Patients. This system consist of a pressure demand valve that attached to a face mask or oral piece, when the patient breathing in it, the stream of gas will go through the valve due to a negative pressure in system and it is continuing until end of inspiration and while stops, expiration will go out via this system. Nitrous Oxide/Oxygen mixtures are temperature sensitive. Nitrous oxide begins to separate out from the mixture if the temperature falls below about -6°C. A homogenous mixture is again obtained when the temperature is raised to above 10oC and the cylinder agitated. Before use, to ensure it is properly mixed, cylinders should be stored horizontally for 24 hours at a temperature above 10oC. If this is not practicable, before use the cylinders must be maintained at a temperature above 10oC for at least 2 hours and then completely inverted three times or placed in warm water at body temperature for 5 minutes and then completely inverted three times.

After Sale Service

Darmangaz company is ready for servicing to medical centers in thorough the country by 30 active agency and handing over the "MIXING OF MEDICAL GASES Entonox", "N2O" in short period of time, while to comfort the respective buyers; preparing the cylinder and relevant equipments and past selling services will be done by the agencies.

educational video Entonox

LIVOPAN - Medicinal Nitrous Oxide/Oxygen Mixture - DarmanoX