Nitrous oxide procedural sedation in non-fasting pediatric patients undergoing minor surgery: a 12-year experience with 1,058 patients.
BACKGROUND
Nitrous oxide's safety and efficacy for minor procedures is an alternative to general anesthesia, complex sedation protocols, or local anesthetic alone.


METHODS
A retrospective review of prospectively-collected data (2000-2012) identified 1,058 children who received single-agent nitrous oxide for minor surgery.


RESULTS
Children (n = 1,058, male 42 %, female 58 %) aged 1-23 years (mean = 9.8 + 5.1 years) were identified. Only nine children (0.9 %) fasted. ASA status was I-II in 1,053 (99.5 %) of patients; five (0.5 %) had an ASA III. There were no major complications (desaturation, emergency admission, apnea, airway obstruction, bradycardia) or aborted procedures. Minor complications occurred in 1.8 %; there was no association between these complications and ASA, fasting status or maximum nitrous oxide percentage administered (all p > 0.05). Post-operatively, 98 % of patients denied getting an injection. Eighty-two percent reported mild or no procedural pain.


CONCLUSIONS
This is the longest reported study using non-anesthesiologist-administered nitrous oxide as a single-agent for minor surgical procedures. The technique provides safe sedation and excellent amnesia, allowing pain and anxiety-reduced surgery with no fasting or postoperative monitoring.
Department of Pediatric Surgery, Miami Children's Hospital, 3200 SW 60 Court, Suite 201, Miami, FL, 33155, USA, raquel.pasaron@mch.om.
Raquel
R
Pasarón
Cathy
C
Burnweit
Jeannette
J
Zerpa
Leopoldo
L
Malvezzi
Colin
C
Knight
Tina
T
Shapiro
Carmen
C
Ramos-Irizarry
Evelio
E
Velis
D000293:Adolescent; D018685:Anesthetics, Inhalation; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives; D007223:Infant; D008297:Male; D013511:Minor Surgical Procedures; D009609:Nitrous Oxide; D012189:Retrospective Studies; D055815:Young Adult
D018685:Anesthetics, Inhalation; D006993:Hypnotics and Sedatives; D009609:Nitrous Oxide