Continuous flow 50:50 nitrous oxide:oxygen is effective for relief of procedural pain in the pediatric emergency department

摘要

To determine applicability of continuous flow 50:50 N_2O:oxygen during painful procedures in our university-hospital pediatric emergency department (ED). Methods: Children scheduled to undergo a painful procedure were enrolled consecutively. 50:50 N20:oxygen was provided throughout the procedure. Pain was evaluated using a numerical pain scale (0: no pain to 10: unbearable pain) by children >6 years old, medical providers and parent. Duration of N_2O inhalation, recovery time, side effects, provision and type of supplementary analgesics were recorded. Results: Fifty-nine children, 0.5-15 years enrolled and 55 comprised the final study cohort. Pain scores, as reported by the different observers, were low. N_2O administration was more beneficial in children >3 versus <3. Under N_2O, pain during infiltration of the skin with lidocaine was higher than during suturing. Children returned to pre-inhalation behavior by a mean of 2.7(+-) 1.6min. Vomiting, the most common side effect, occurred in five (9.0%) children. All parents reported that they would be willing for their child to use N_2O again, if necessary. Conclusions: Continuous flow 50:50 N_2O:oxygen is effective for procedural pain in the pediatric ED. It is agreeable to children, particularly >3 years old, medical providers and parents, provides short recovery times and bears minor adverse effects.