Effectiveness of 50% Nitrous Oxide/50% Oxygen during Laceration Repair in Children

• Published in: Academic emergency medicine 1998-02, Vol.5 (2), p.112-117
• Main Authors: Burton, John H., Auble, Thomas E., Fuchs, Susan M.
• Format: Article
• Language: English
• Subjects: analgesia; Analgesics, Non-Narcotic; Anesthetics, Inhalation; Anti-Anxiety Agents; anxiety; Child; Child, Preschool; Double-Blind Method; Drug Therapy, Combination; emergency department; Humans; laceration; nitrous; Nitrous Oxide - administration & dosage; oxide; Oxygen - administration & dosage; Pain Measurement; pediatric sedation; Prospective Studies; Treatment Outcome; wound; Wounds and Injuries - surgery
• ISSN: 1069-6563; 1553-2712
• DOI: 10.1111/j.1553-2712.1998.tb02594.x

ABSTRACT Objective: To determine the effect of an inhaled 50% nitrous oxide/50% oxygen mixture on measures of observed anxiety in children during laceration repair. Methods: A prospective, randomized, placebo‐controlled, double‐blind comparison of an inhaled 50% nitrous oxide/50% oxygen mixture (treatment group) with 100% oxygen (control group) during repair of lacerations was performed. The study population was a convenience sample of children aged 2–7 years in an urban pediatric ED. The primary outcome variable was the change in scores before and during laceration repair with a 10‐point modified Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) assessment. The secondary outcome variable was a 4‐point anxiety scale measured before and during the procedure. Results: Thirty patients were entered into the study. Seventeen children inhaled the 50% nitrous oxide/oxygen mixture and 13 inhaled 100% oxygen during laceration repair. There was no statistically significant difference in initial CHEOPS and anxiety scores between the 2 groups (p = 0.687 and 0.809, respectively). The median CHEOPS scores in the treatment group decreased by 5 points, while those of the control patients increased by 3 (p < 0.001). The median anxiety scores in the treatment population decreased by 1 point, with an increase of 1 for the control patients (p < 0.001). Conclusion: Administration of a 50% nitrous oxide/50% oxygen mixture to children during their laceration repair resulted in a significant decrease in measures of anxiety when compared with inhalation of 100% oxygen.