Nitrous Oxide, From the Operating Room to the Emergency Department

Huang, Christine; Johnson, Nathaniel

doi:10.1007/s40138-016-0092-3

Cited by 37 publications

(30 citation statements)

References 49 publications

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“…Efforts to ameliorate anxiety prior to vascular access include pharmacologic and nonpharmacologic modalities . Oral anxiolytics such as midazolam, intranasal dexmedetomidine, and inhaled nitrous oxide have been shown to be effective in reducing anxiety and increase compliance prior to vascular access . However, the majority of pediatric patients undergoing vascular access are not in clinical settings that offer these interventions, some of which require additional trained personnel .…”

Section: Introductionmentioning

confidence: 99%

“…4 Oral anxiolytics such as midazolam, intranasal dexmedetomidine, and inhaled nitrous oxide have been shown to be effective in reducing anxiety and increase compliance prior to vascular access. 4,5 However, the majority of pediatric patients undergoing vascular access are not in clinical settings that offer these interventions, some of which require additional trained personnel. 4 Nonpharmacologic interventions include coaching, often completed by certified child life specialists (CCLS), and distraction techniques using a variety of tools.…”

Section: Introductionmentioning

confidence: 99%

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Virtual reality during pediatric vascular access: A pragmatic, prospective randomized, controlled trial

Caruso

George

Menéndez

et al. 2019

Pediatric Anesthesia

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Background Vascular access is a minor procedure that is associated with reported pain and fear in pediatric patients, often resulting in procedural incompliance. Virtual reality has been shown to be effective in adult populations for reducing pain and anxiety in various medical settings, although large studies are lacking in pediatrics. Aims The primary aim was to determine whether pain would be reduced in pediatric patients using virtual reality undergoing vascular access. The four secondary aims measured patient fear, procedural compliance, satisfaction, and adverse events. Methods A prospective, randomized, controlled trial was completed at a pediatric hospital, enrolling children 7‐18 years old undergoing vascular access in a variety of clinical settings, randomized to virtual reality or standard of care. Pain scores were measured using a numeric pain faces scale. The secondary outcomes of patient fear, procedural compliance, satisfaction, and adverse events were measured with the Child Fear Scale, modified Induction Compliance Checklist, and satisfaction surveys, respectively. Chi‐squared, t tests, and regression models were used to analyze the results. Results The analysis included 106 patients in the virtual reality group and 114 in the control. There were no significant differences in postprocedure pain (VR group estimated 0.11 points lower, 95% confidence interval: 0.50 points lower to 0.28 points greater, P = .59), postprocedure fear (VR group estimated 0.05 points lower, 95% confidence interval: 0.23 points lower to 0.13 points greater), or compliance (adjusted odds ratio 2.31, 95% confidence interval: 0.96‐5.56). Children in the virtual reality group were satisfied with the intervention. There were no adverse events. Conclusion This study demonstrates no reduction in pain while using Virtual reality (VR) across a heterogeneous pediatric inpatient population undergoing vascular access.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Virtual reality during pediatric vascular access: A pragmatic, prospective randomized, controlled trial

Caruso

George

Menéndez

et al. 2019

Pediatric Anesthesia

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“…The efficacy and safety of N 2 O is well established, particularly in the pediatric emergency department. Using N 2 O alone can help facilitate performing painful and/or anxiety-provoking procedures such as the reduction of fractures and repair of lacerations 14 . Nitrous oxide seems safe for children of all ages.…”

Section: Discussionmentioning

confidence: 99%

Inhaled nitrous oxide can reduce the pain perception in post Caldwell-Luc operation patients–a randomised trial

Liu

2017

Sci Rep

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To assess the efficiency of inhaled nitrous oxide (N2O) for the reduce the perception pain in extraction of iodoform gauze packing strips in post Caldwell-Luc operation patients. This randomized single blind trial included a total of 47 patients, aged between 14–82 years, in which undergoing radical maxillary sinusotomy. Based on the randomization procedure, patients were treated with (experimental) or without (control) inhaled N2O. The visual analogue scale scores (VAS scores) of the pain perception and the headache duration time were comparatively studied. The average VAS score for pain perception was 3.92 in the N2O group and 7.87 in the control group. The average headache duration time was 0.12 hour in the N2O group and 13.09 hours in the control group. Both VAS scores for pain perception during the treatment and the average headache duration time were significantly reduced in the inhaled N2O group (P < 0.01). Reduced pain perception and headache duration time indicated that, the inhaled N2O method might be viable in extraction of iodoform gauze packing strips in post Caldwell-Luc operation patients.

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“…Since its initial introduction in 1844 by an American dentist named Horace Wells for pain control during tooth extraction, N 2 O has been widely used in dentistry to control the pain and distress in patients [ 6 ]. N 2 O is an odorless and colorless gas with anxiolytic, analgesic, and amnestic properties, along with rapid onset and recovery, which represent the ideal characteristics of a sedative [ 6 7 ]. Moreover, as a major advantage of using N 2 O is the mitigation of needle phobia [ 7 ], it is therefore commonly to achieve PSA in pediatric patients.…”

Section: N 2 O For Procedural Sedation and Analgesmentioning

confidence: 99%

Complications caused by nitrous oxide in dental sedation

2018

J Dent Anesth Pain Med

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The first clinical application of nitrous oxide (N2O) was in 1844, by an American dentist named Horace Wells who used it to control pain during tooth extraction. Since then, N2O has shared a 170-year history with modern dental anesthesia. N2O, an odorless and colorless gas, is very appealing as a sedative owing to its anxiolytic, analgesic, and amnestic properties, rapid onset and recovery, and, in particular, needle-free application. Numerous studies have reported that N2O can be used safely and effectively as a procedural sedation and analgesia (PSA) agent. However, N2O can lead to the irreversible inactivation of vitamin B12, which is essential for humans; although rare, this can be fatal in some patients.

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Nitrous Oxide, From the Operating Room to the Emergency Department

Cited by 37 publications

References 49 publications

Virtual reality during pediatric vascular access: A pragmatic, prospective randomized, controlled trial

Virtual reality during pediatric vascular access: A pragmatic, prospective randomized, controlled trial

Inhaled nitrous oxide can reduce the pain perception in post Caldwell-Luc operation patients–a randomised trial

Complications caused by nitrous oxide in dental sedation

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