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What Is ProNox?
ProNox is an innovative analgesia system that involves the use of a patient-controlled, 50/50 combination of nitrous oxide and oxygen to minimize anxiety and discomfort from a procedure under local anesthesia. Nitrous oxide is a well-known sedative (once called laughing gas) that calms the central nervous system, allowing patients to feel comfortable during necessary or elective procedures.
What is ProNox used for?
The combined use of nitrous oxide and oxygen is not new to medicine. This method of mild sedation has been used around the world for more than a century. Most recently, the use of nitrous oxide and O2 has been recognized as a common way to manage dental anxiety during routine, restorative, and cosmetic procedures. Historically, this sedation method has been used in labor and delivery, during stem-cell therapy and cosmetic treatments such as microneedling, and even during surgical procedures such as breast augmentation and tummy tuck surgery.
How is ProNox administered?

ProNox is delivered by inhalation at the discretion of the patient making it an appealing and highly request this service since the controlled sedative effects are in the hands of the patient – literally. This aspect alone, regardless of the proven effects of nitrous oxide, have a calming effect on patients who may feel nervous about their treatment.

Will I feel anything during my procedure?

ProNox is not a replacement for a local anesthetic, although nitrous oxide does have an analgesic effect. When a patient uses the ProNox systemthe central nervous system slows down in terms of responsiveness. A natural byproduct of this is the enhancement of other pain medications. Patient comfort is a high priority to us, and we have elected to incorporate ProNox as a way to complement the effects of local anesthetic such as lidocaine for surgical and non-surgical procedures. Because nitrous oxide does not put a patient “to sleep,” like general anesthesia does, communication between patient and staff can provide consistent feedback to manage comfort levels.

Is ProNox safe?

The ProNox system is based on a long-history of success using nitrous oxide as a calming agent and analgesic. Nitrous oxide has been safely used for more than a century in dermatologic, surgical, and dental settings. ProNox has  internal safety mechanisms such as infection control via a one-way delivery valve and an automatic shut-off if either nitrous oxide or oxygen levels in the machine become too low.

Can I drive home after using ProNox?

In comparison to oral and IV sedatives, the advantage of nitrous oxide is that the calming effects occur rapidly and dissipate within about 5 minutes after the completion of treatment. Due to this fast-action, patients need not arrive for appointments early nor are they required to arrange transportation to and from their appointments. Once the effects of nitrous oxide wear off, normal activities can be resumed. In cases where the specific procedure would not preclude driving, patients using ProNox can drive home after their treatment.

Your ProNox Treatment will be performed in Dr. Praful Ramineni‘s surgery center located in Washington, DC.

This has been an amazing experience from the consultation to post-surgery!!! I honestly can’t even express how happy & grateful I am with the results. Everyone….Dr. Ramineni and his whole team are impeccable, to say the least. A very thoughtful, professional, kind, and knowledgable team. I will 100% always refer anyone I know to this amazing team…Dr. Ramineni had a challenge when I came to see him with my issue but he 1000% went above & beyond to achieve perfection with my results. I can’t thank this team enough!! I genuinely want to thank you so much!

- Sally T.

Dr. Ramineni was recommended to me by my plastic surgeon as a masterful surgeon who could figure out why I was having complications. He diagnosed the problem correctly and fixed it. I am grateful for his openness, his honesty, and skill.

- Saiyyaed A.

Life-altering surgeon. He helped make my dreams come true with the most flawless surgery I’d been waiting my whole life to get. Healing and recovery has been almost disturbingly easy and pain-free. I could not recommend enough. Everyone there is so sweet as well!

- Katie C.

Dr. Praful Ramineni



Dr. Ramineni is the founder of District Plastic Surgery. He is board certified and has over 15 years of experience in plastic and reconstructive surgery. He started his career as one of the busiest surgeons at Medstar Washington Hospital Center with a focus on complex reconstructive surgery including cancer and trauma reconstruction, microsurgery and aesthetic surgery.

Dr. Praful Ramineni

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