Sponsored by CAREstream;
Pro-Nox™ by CAREstream America (Lake Mary, Fla.) is helping aesthetic practices empower thousands of patients around the world to take control of their fears and get the treatments they desire by providing a Pro-Nox Comfort Zone. Medical procedures, even nonsurgical aesthetic treatments, are a common source of anxiety and fear due to needle phobias or sensitivity to pain. These issues can interfere with patient compliance and create a barrier to cosmetic procedures that evoke even the slightest anxiety. With Pro-Nox, aesthetic physicians can provide the stress management and comfort patients need, with a delivery system that has been proven safe and effective for over six years.
The use of nitrous oxide (N2O) has long been associated with dentistry to help ease discomfort, anxiety and phobias, while the medical industry has embraced topical anesthetics and oral pain relievers, which can take up to 60 minutes to take effect. Pro-Nox is stepping in to change the way aesthetic physicians manage the stress and discomfort that accompanies minimally invasive surgeries, as well as common treatments such as radiofrequency (RF) microneedling, laser treatments and platelet-rich plasma (PRP) injections.
What is Pro-Nox?
Pro-Nox is a gas delivery system that provides a 50/50 mix of N2O and oxygen for pain relief and stress reduction. Unlike other N2O delivery systems, Pro-Nox allows the patient to control their own level of sedation. “Our patients have felt very comfortable with the self-administration aspect that allows them control based on how they feel,” reported Gilly Munavalli, MD, medical director and founder of Dermatology, Laser & Vein Specialists of the Carolinas (Charlotte, N.C.). “The added analgesic effect has really provided our patients with an extra measure of comfort. For those with needle-phobic tendencies, as well as for younger adolescent patients, Pro-Nox has been a godsend.”
Anna Petropoulos, MD, a board-certified facial plastic surgeon at The New England Facial & Cosmetic Surgery Center in Boston, Mass., explained that N2O is a natural anxiolytic that helps alleviate patient fears. “Alleviating our patients’ preconceived anxiety about a treatment is as important as ensuring their comfort,” she shared. “Once we alleviate our patients’ fears and worries, we can deliver better outcomes and focus on their treatments and not be distracted with managing their anxiousness.”
Dr. Petropoulos explained that Pro-Nox is FDA cleared as an analgesic device and does not fall under the anesthesia category. “Safety guidelines are recommended for systems that deliver more than 50% N2O, which include having crash carts and airway management equipment available,” she reported. “The American Society of Anesthesiology (ASA) classifies the use of 50% or less N2O, which is the case with Pro-Nox, as minimal sedation with minimal risks. The Pro-Nox Demand Valve Delivery feature offers a fixed delivery of 50% N2O and 50% O2, which virtually eliminates the loss of consciousness.”1
Pro-Nox’s safety features extend beyond certifications to provide a system that patients can trust. “N2O does not flow unless the patient is holding the breathing tube securely in their mouth and inhaling the gas mixture,” Dr. Petropoulos continued. “Pro-Nox also offers special filters in their single-use, single-patient breathing tubes that eliminate 99.5% of any airborne viruses or bacteria. Proper training and certification also come with the purchase of a Pro-Nox system.”
Benefits for Both Patients and Physicians
For many patients, aesthetic treatments and procedures are now considered more than a luxury, and with social media the public is more educated than ever. With this in mind, cosmetic physicians are beginning to enhance their patients’ comfort with Pro-Nox and give them control of their analgesia during most non-surgical procedures. Relaxed patients allow physicians and practitioners to do their best work.
Arisa Ortiz, MD, a board-certified dermatologist and associate professor of dermatology at UC San Diego in San Diego, Calif., uses Pro-Nox in her practice to ensure her patients enjoy a pleasant and comfortable experience during their in-office procedures. “When it comes to more painful procedures, or working with patients that are more anxious, Pro-Nox has been crucial. It provides patients with another level of comfort, and when patients are relaxed and comfortable, I can provide optimal treatments more efficiently,” she explained. “If I have a patient who is uncomfortable or anxious, I am able to quickly bring in Pro-Nox and put them at ease within seconds.”
Dr. Munavalli also finds that helping his patients relax allows him to provide the highest level of treatment. “We can use Pro-Nox alone or we can use it to supplement topical and injectable anesthesia with some of our more complicated treatments or our more sensitive patients. Comfortable patients allow us to utilize our toolbox of devices and device settings in a much more effective way. Pro-Nox provides that level of comfort for our patients,” he reported.
Dr. Petropoulos reiterated that the anxiolytic properties of Pro-Nox help calm fears and phobias, such as needle phobia, which can make it easier for physicians to administer toxins, dermal fillers and PRP. In her opinion N2O has become the best new option to ensure their patients are comfortable during treatments that would normally be considered quite painful.
“Our other options like numbing creams, oral medications, cold air and vibration devices do not give the same level of pain management as we get with N2O,” she added.
Many aesthetic treatments require more than one visit, but patient compliance can be a challenge if the procedure is uncomfortable or painful. Nitrous oxide can help reduce the anxiety that comes with energy-based procedures and offer patients the comfort they need to give them confidence to complete their treatment series. Dr. Petropoulos explained that the N2O system will also stimulate wellness endorphins and mask the sensation of pain, making return sessions easier.
“Our patients always want to know if a new treatment is painful. We can now answer this with confidence,” stated Dr. Petropoulos. “With Pro-Nox, we can provide a better experience and our patient compliance is better than ever. I do not want to forget that our staff also enjoys a better experience since they do not have to spend their day coaching patients through discomfort. And since the effects of N2O only last several minutes, once the treatment is over and the patient stops inhaling, they can drive home safely.”
“After just over a thousand patient treatments in our office, we can say without hesitation that Pro-Nox has been one of our most sensible and effective practice purchases,” Dr. Munavalli stated.
Users agree Pro-Nox is changing the way aesthetic practices manage patient anxiety and pain, and may soon lead to a new standard of care in the industry.
1. An Updated Report by the American Society of Anesthesiologists Task Force on Sedation and Analgesia by Non-Anesthesiologists; Practice Guidelines for Sedation and Analgesia by Non-Anesthesiologists. Anesthesiology 2002; 96:1004–1017 doi: https://doi. org/10.1097/00000542-200204000-00031