[Efficacy and safety of inhalation premixed nitrous oxide and oxygen for the management of procedural diagnostic pain in neuropediatrics].
OBJECTIVE
We studied the use of premixed nitrous oxide and oxygen in 80 patients with neurologic diseases.


METHODS
Mean ages ranged 10 +/- 5 yrs. Twenty-three patients (29%) were mentally retardated among which 17 of them presented with severe epilepsy. Painful procedures consisted of: lumbar punctures (80%), intravenous access (7), gastric endoscopy (6), skin biopsy (4), gastrostomy tube management (3). High-risk children were continuously monitored using ECG, non invasive blood pressure and transcutaneous oxygen saturation. We studied acceptation of the inhalation, vital signs, satisfaction of children, parents, medical and nursing staffs; side effects were compared with a group of healthy children undergoing venous access before induction of anesthesia.


CONCLUSIONS
Acceptation increased with age. No significant changes in vital signs variables were observed. Satisfaction rate regarding the method was 88% for all children, parents, physicians and nurses. No serious undesirable event (as respiratory depression, seizure, inhalation of gastric content) occurred in these patients. The more frequent side-effects were: drowsiness during and after inhalation (35 and 9% respectively in the handicapped patients); nausea and vomiting (8%), headaches (3%), were more frequent than reported in literature but there were 25% of meningitis among our patients.


CONCLUSIONS
Premixed nitrous oxide and oxygen was effective for reducing procedural pain and anxiety in children with neurological disorders, even in severely handicapped patients, with minor side-effects.
Lévêque
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Département d'anesthésie-réanimation, hôpital Saint-Vincent-de-Paul, 82, avenue Denfert-Rochereau, 75014 Paris, France. doclevq@yahoo.com
Mikaeloff
Y
Y
Hamza
J
J
Ponsot
G
G
D000280:Administration, Inhalation; D000293:Adolescent; D000328:Adult; D001706:Biopsy / Q000009:adverse effects; D002406:Catheterization, Peripheral / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D016292:Procedural Sedation / Q000009:adverse effects / Q000379:methods* / Q000523:psychology; D016903:Drug Monitoring; D004562:Electrocardiography; D005260:Female; D005773:Gastroscopy / Q000009:adverse effects; D005774:Gastrostomy / Q000009:adverse effects; D006801:Humans; D008607:Intellectual Disability / Q000150:complications; D008297:Male; D009584:Nitrogen / Q000627:therapeutic use*; D010092:Oximetry; D010100:Oxygen / Q000627:therapeutic use*; D010146:Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology* / Q000523:psychology; D010147:Pain Measurement; D017060:Patient Satisfaction; D013129:Spinal Puncture / Q000009:adverse effects; D016896:Treatment Outcome
C041364:nitrox; D009584:Nitrogen; D010100:Oxygen