Effective reduction of anxiety and pain during venous cannulation in children: a comparison of analgesic efficacy conferred by nitrous oxide, EMLA and combination

Hee, Hwan-Ing; Goy, Raymond; Ng, Agnes Suah-Bwee

doi:10.1046/j.1460-9592.2003.01051.x

Cited by 56 publications

(33 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The notable finding in the mentioned study was that in older children, avoidance behaviors improved by entonox (19). The effect of the underlying variable of age on entonox efficiency during PSA is an important finding that unfortunately was not assessed in the present study.…”

Section: Discussionmentioning

confidence: 61%

Entonox Efficacy for Procedural-Sedation and Analgesia in Pediatrics Undergoing Bone Marrow Aspiration: A Randomized Clinical Trial

Hashemieh

Memari

Taheri

2017

Iran Red Crescent Med J

View full text Add to dashboard Cite

Background: The current study aimed at investigating the effect of using entonox gas during sedation and analgesia induction in pediatric candidates of bone marrow aspiration. Methods: It was a single-blind, randomized clinical trial. All pediatric candidates of 1st time bone marrow aspiration were included and allocated to either group 1 or 2, using a random number table. In group 1, a combination of midazolam, fentanyl, ketamine, and propofol was injected intravenously. In group 2, the mentioned combination was injected intravenously and entonox gas was used for patients' ventilation. The goal was to reach level 4 sedation based on the Ramsay sedation scale. If needed, extra propofol was injected intravenously every minute. Physician and the helping nurse satisfaction of the procedure were evaluated. Duration of the procedure, the administered dosage for each patient, occurrence of any complications, and the recovery time were recorded.

show abstract

Section: Discussionmentioning

confidence: 61%

Entonox Efficacy for Procedural-Sedation and Analgesia in Pediatrics Undergoing Bone Marrow Aspiration: A Randomized Clinical Trial

Hashemieh

Memari

Taheri

2017

Iran Red Crescent Med J

View full text Add to dashboard Cite

show abstract

“…Eutectic mixture of local anesthetics with lidocaine and prilocaine (EMLA cream) is similarly effective in giving venipuncture pain relief in pediatric patients [6][7][8]. However, school-aged children would be aware of the needle and therefore show anxiety due to their expectation of pain associated with venipuncture [7,8]. Application of EMLA cream sometime induces vasoconstriction, which may result in difficulty in venous cannulation [8].…”

Section: Discussionmentioning

confidence: 99%

“…However, school-aged children would be aware of the needle and therefore show anxiety due to their expectation of pain associated with venipuncture [7,8]. Application of EMLA cream sometime induces vasoconstriction, which may result in difficulty in venous cannulation [8]. Thus, N 2 O may be advantageous over EMLA cream in reducing pain-related anxiety.…”

Section: Discussionmentioning

confidence: 99%

“…However, we have observed pain and anxiety amongst many of the children during venipuncture because the interval between time of oral premedications and admittance to the OR is irregular and sedative effects are variable. As nitrous oxide (N 2 O) produces rapid onset and elimination of analgesic effects and mild sedation, it may be effective in reducing pain and anxiety during pediatric venous access [4][5][6][7][8][9][10]. One report showed that 70% N 2 O in oxygen (O 2 ) was more effective than 50% N 2 O in O 2 in reducing venipuncture pain in children [4].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The effective time and concentration of nitrous oxide to reduce venipuncture pain in children

Furuya¹,

Ito²,

Fukao³

et al. 2009

Journal of Clinical Anesthesia

View full text Add to dashboard Cite

“…In terms of short-acting topical anesthetic prior to needle procedures, some interesting novel therapies appear promising [112][113][114]. Pain Ease Ò is a vapocoolant spray that acts in less than a minute; it contains 1,1,1,3,3-pentafluoropropane and 1,1,1,2-tetrafluoroethane and was shown in an RCT to reduce intravenous cannulation-related pain in children aged 6-12 years and to improve the success rate of cannulations [115].…”

Section: Topical Anestheticsmentioning

confidence: 99%

Managing Pediatric Pain in the Emergency Department

Bailey

Trottier

2016

Pediatr Drugs

View full text Add to dashboard Cite

Far more attention is now given to pain management in children in the emergency department (ED). When a child arrives, pain must be recognized and evaluated using a pain scale that is appropriate to the child's development and regularly assessed to determine whether the pain intervention was effective. At triage, both analgesics and non-pharmacological strategies, such as distraction, immobilization, and dressing should be started. For mild pain, oral ibuprofen can be administered if the child has not received it at home, whereas ibuprofen and paracetamol are suitable for moderate pain. For patients who still require pain relief, oral opioids could be considered; however, many EDs have now replaced this with intranasal fentanyl, which allows faster onset of pain relief and can be administered on arrival pending either intravenous access or definitive care. Intravenous opioids are often required for severe pain, and paracetamol or ibuprofen can still be considered for their likely opioid-sparing effects. Specific treatment should be used for patients with migraine. In children requiring intravenous access or venipuncture, non-pharmacological and pharmacological strategies to decrease pain and anxiety associated with needle punctures are mandatory. These strategies can also be used for laceration repairs and other painful procedures. Despite the gaps in knowledge, pain should be treated with the most up-to-date evidence in children seen in EDs.

show abstract

Effective reduction of anxiety and pain during venous cannulation in children: a comparison of analgesic efficacy conferred by nitrous oxide, EMLA and combination

Abstract: EMLA and 50% N2O are equally effective for pain reduction while a combination technique provides superior analgesia and satisfaction. N2O has an advantage over EMLA in reduction of pain related behaviour in older children.

Cited by 56 publications

References 33 publications

Entonox Efficacy for Procedural-Sedation and Analgesia in Pediatrics Undergoing Bone Marrow Aspiration: A Randomized Clinical Trial

Entonox Efficacy for Procedural-Sedation and Analgesia in Pediatrics Undergoing Bone Marrow Aspiration: A Randomized Clinical Trial

The effective time and concentration of nitrous oxide to reduce venipuncture pain in children

Managing Pediatric Pain in the Emergency Department

Contact Info

Product

Resources

About