Utilizzo del protossido di azoto nella riduzione del dolore e dell’ansia da procedura in Pediatria

Abstract

<b>Background -</b> To prevent and control the procedural pain includes an adequate analgesia and the reduction of the anxiety/distress related to the procedure itself. A useful tool that combines the analgesic and sedative effects is nitrous oxide combined in different percentages with oxygen. <br> <b>Objective -</b> The goal of this study is to evaluate the efficiency of the nitrous oxide in the management of procedural pain and distress in a paediatric environment, also considering the possibility that a pre-made solution of nitrous oxide and oxygen 50/50 could be given independently of the inmate by a properly trained nurse. <br> <b>Methods -</b> An observational study at the Paediatric First Aid Department in Sant’Anna Hospital (Como, Italy) was performed by creating a special procedure that was applied to children older than 1 year old that needed to undergo low to mild painful procedures between July 6th 2017 and December 31st 2019. The blend was dosed by a demand valve. For each procedure a form was filled in with personal data, side effects, parameters and an evaluation of the pre-procedure and post-procedure pain. All the staff then took a satisfaction questionnaire.<br> <b>Results -</b> The study corroborates that preblended nitrous oxide 50/50 is safe and efficient, and also guarantees analgesic and anxiolytic effects for a vast case of mildly painful procedures. The little use of other drugs and the absence of opioids in the treatment is likely the main reason for the absence of major side effects. <br> <b>Conclusions -</b> The collected data suggest that a 50/50 blend of nitrous oxide and oxygen is still used considering its efficiency and manageability in the procedural sedation and also confirm that using the same concentrations and avoiding combination with opioids is safe and available to properly formed nurses.