Effectiveness of 50% nitrous oxide/50% oxygen during laceration repair in children.
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).


CONCLUSIONS
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.
Burton
J H
JH
Department of Emergency Medicine, Maine Medical Center, Portland 04102, USA. jburton@pol.net
Auble
T E
TE
Fuchs
S M
SM
D018712:Analgesics, Non-Narcotic; D018685:Anesthetics, Inhalation; D014151:Anti-Anxiety Agents; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D006801:Humans; D009609:Nitrous Oxide / Q000008:administration & dosage; D010100:Oxygen / Q000008:administration & dosage; D010147:Pain Measurement; D011446:Prospective Studies; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000601:surgery*
D018712:Analgesics, Non-Narcotic; D018685:Anesthetics, Inhalation; D014151:Anti-Anxiety Agents; D009609:Nitrous Oxide; D010100:Oxygen