How does RA sedation work?
At R A Medical, we provide a range of medical-grade equipment designed for the safe and effective delivery of inhalation sedation. Inhalation sedation, also known as relative analgesia (RA), is a technique that combines medical-grade oxygen with carefully controlled levels of nitrous oxide to help patients feel relaxed, calm, and more comfortable during procedures.
Our systems are designed to precisely mix and deliver oxygen and nitrous oxide through a nasal mask or mouthpiece. The clinician sets and monitors the gas levels throughout the procedure, ensuring a consistent and safe experience tailored to each patient.
As the patient breathes normally through the mask, the sedative effects take place quickly, helping to reduce anxiety and discomfort while allowing the patient to remain conscious and responsive.
At the end of the procedure, patients are given 100% oxygen to flush out any remaining nitrous oxide. In most cases, this allows patients to recover quickly and resume normal activities soon after. Discharge suitability — including the ability to drive — should always be assessed by the clinician in line with clinical guidelines and the individual patient’s condition.
What can you provide using RA?
RA Inhalation Sedation is an incredibly versatile form of pain relief. It provides mild pain and anxiety relief which works hand-in-hand with local anaesthetics — enhancing their effect while also keeping the patient calm. Incredibly helpful for people who have a fear of needles.
Digital or Analogue?
When it comes to choosing between digital and analogue RA units, there is not a one-size-fits-all answer — it comes down to personal preference and practice needs.
Trusted, tactile, proven
- ▸Accuracy & Precision: many clinicians value the fine control analogue systems provide.
- ▸Reliability: trusted, established technology with a long track record.
- ▸Familiarity: if you trained on analogue equipment, you may find them more intuitive.
Modern, clean, feature-rich
- ▸Ease of Use: simple interface and clear displays make them user-friendly.
- ▸Modern Design: sleek build and often lighter to handle.
- ▸Features: some models offer additional functions that streamline daily use.
The best RA machine is the one you will feel most confident using day after day. Think about what you are already familiar with and how it will fit into your practice workflow.
Demand Flow vs Continuous Flow
There are two main types of flow that a machine can offer. Demand flow and continuous flow. But what is the difference?
Demand Flow
Gas is delivered only when the patient inhales. The flowmeter activates when the patient breathes, supplying gas on demand. No gas flows during exhalation or pauses in breathing.
- ✓ More efficient gas usage
- ✓ Allows better access to the face during procedures (mask/mouthpiece can be moved)
- ✓ Lets the patient self-administer sedation to their needs
Continuous Flow
Gas is delivered at a continuous rate regardless of the patient’s breathing. Gas flow and Nitrous Oxide percentage is set manually. Gas flow must be controlled and monitored by clinician.
- ✓ A simple and more predictable delivery of gas
- ✓ The most common option of gas delivery on the majority of our units
- ✓ Uses more gas overall
Scavenging waste gases
Once you have chosen the RA machine that best suits your practice, the next step is to make sure you can safely scavenge waste gases. Effective scavenging is essential for both staff safety and compliance.
MiniScav
The MiniScav is a portable and compact unit designed to pump waste gas out of your practice. The unit is easy to install, and requires minimal disruption. In fact, all that is needed is a 16 mm vent hole through an external wall and you are ready to go.
🐾 Ralph’s Top Tip: The MiniScav is the most popular choice for clinics as it is quick to install, easy to use, and reliable.
Cylinder & Machine Storage
The next step is thinking about where and how to store your equipment safely. Here is a checklist for your clinic.
Ease of Access
Cylinders will need to be delivered and collected, so make sure your supplier has clear, safe access in and out of the building.
Cylinder Requirement
Always keep spare cylinders on site in case you run out of gas. The number of spares depends on your usage, but all cylinders must be stored safely.
Security & Safety
Cylinders should be locked away when not in use. It is also best practice to inform your local fire department that cylinders are stored on site.
Ventilation
Ideally, the storage room should have external ventilation. If this is not possible, install a low-level louvre panel in the door.
Brackets
Cylinders should be stored using wall brackets wherever possible. E-size cylinders may be laid flat, but they must not be stacked.
Cylinder Identification
If space allows, keep full and empty cylinders separate. If not, clearly label all cylinders as full, empty, or faulty.
Combustion
Never store cylinders near materials that could support combustion or close to electrical equipment.
Signage
Place a green compressed gas sign on the storage room door. If not already displayed elsewhere, add a No Smoking sign to the same door.
RA Sedation Flowmeters
Three flowmeters commonly used in aesthetics clinics. The Nitronox Plus is the most popular choice for self-administered demand-flow sedation, while the Midas and MDM offer more traditional clinician-controlled options.
Porter Nitronox Plus
The Nitronox Plus is a demand-flow system used to manage pain and anxiety during minimally invasive procedures, delivering a precise nitrous oxide and oxygen mixture that patients self-administer via a mask or mouthpiece.
- ✓0–50% and 0–70% adjustable N₂O demand flow models
- ✓Key lock mechanism for safety and security
- ✓Audible low gas pressure alarm
- ✓Safety function test button
The Porter Nitronox Plus offers a simple, reliable way to enhance patient comfort while keeping procedures efficient and stress-free. It is a versatile solution that fits seamlessly into a wide range of clinical settings, helping improve the overall patient experience without adding unnecessary complexity to your workflow.
Porter Midas
The Porter Midas flowmeter brings modern design to RA sedation. With its sleek touchscreen interface and "Touch & Slide" controls, it offers both precision and ease of use.
- ✓Touchscreen Control: intuitive, simple to adjust flow and mixture
- ✓High Flow Capacity: delivers up to 18 LPM
- ✓Safety Alerts: audible and visual alarms provide reassurance if anything is not right
- ✓Security: PIN protection helps prevent unauthorised use
- ✓Digital Record Keeping: stores up to 50 sedation sessions, helping you track gas usage
- ✓Flexible Mounting: upright, cabinet, wall, or mobile stand options
The Midas is well-suited to practices that value modern features and a digital workflow. For teams already comfortable with digital technology, it offers added convenience without compromising accuracy or reliability.
Porter Quantiflex MDM
The MDM is a true classic in RA sedation. Its design has remained largely unchanged for decades — and for good reason. As the saying goes: "If it is not broken, do not fix it."
- ✓Flow Control & Mixture Wheel — trusted pairing for excellent accuracy and flexibility
- ✓Proven Reliability — track record of over 30 years
- ✓Familiarity — many clinicians trained on the MDM and continue to prefer it
The Porter MDM is a trusted, precision-focused solution for clinicians who value control and consistency in inhalation sedation. Its intuitive design and reliable performance make it ideal for delivering a smooth, predictable experience for both practitioner and patient, supporting confident treatment across a wide range of procedures.
Breathing Systems
The right breathing system depends on which flowmeter you choose. The Nitronox Disposable Medical Circuit is the partner for the Nitronox Plus; the Silhouette 2 works with all other flowmeters.
Nitronox Disposable Medical Circuit
The Nitronox breathing circuit is specifically designed to be partnered with the Nitronox Plus and takes full advantage of its demand flow feature.
Rather than using a nasal mask system, the Nitronox circuit can be equipped with either a face mask or mouthpiece. This allows for a less invasive mask type and gives the patient full control of when they want the nitrous oxide to be administered.
- ✓Option of face mask or mouthpiece
- ✓Face mask comes in 2 sizes
- ✓Fully single-patient use system
- ✓Compact tubing design
- ✓Works with demand flow system of the Nitronox
- ✓Built-in capnography adaptability
- ✓Latex free
Porter Silhouette 2
The Silhouette 2 Breathing Circuit is Porter’s newest breathing system and improves upon the features of the previous Silhouette system. Uses both autoclavable and single-patient use components.
- ✓Compact nasal hood with cannula barb
- ✓4 sizes of mask to best fit patient
- ✓Autoclavable gas and scav tubing / connectors
- ✓Single-patient use nasal mask and tubing
- ✓Vacuum clip to set flow with vacuum control block
- ✓Clothing clip to attach tubing to patient’s clothes
- ✓Compatible with capnography via adaptor
- ✓Latex free
- ✓Cannot be used with Nitronox Plus
Servicing & Equipment Care
It is highly recommended that your RA equipment is serviced annually to keep it in safe and reliable working order. Regular servicing not only extends the life of your equipment but also ensures compliance and peace of mind for your practice.
You will normally receive an email reminder from us when your service is due. However, if you do not hear from us, please contact us directly so we can arrange a booking.
🐾 Ralph’s Top Tip: Do not wait for your equipment to go wrong — book in your annual service to keep everything running smoothly.
Ready to talk equipment?
By now, you have had a chance to weigh up the different options and hopefully have a clear idea of which RA equipment best suits your needs. If you are ready to proceed, the next step is simple.
1. Email us with the details of the equipment you require.
2. We will send you a personalised quote.
3. Our team are here to help guide your decision if you are still unsure.