Tolerability of an Equimolar Mix of Nitrous Oxide and Oxygen during Painful Procedures in Very Elderly Patients

Bauer, Carole; Lahjibi-Paulet, Hayat; Somme, Dominique; Onody, Peter; Jean, O. Saint; Gisselbrecht, Mathilde

doi:10.2165/00002512-200724060-00006

Cited by 11 publications

(14 citation statements)

References 22 publications

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“…The quality assessment of the included studies are presented in Additional file 2 . For 19 of the studies that used a quantitative descriptive approach, it was unclear if the sample was representative of the population under study [ 21 – 24 , 33 , 38 – 42 , 44 – 52 ]. Furthermore, 13 studies did not provide sufficient information regarding response rate [ 21 , 23 , 24 , 33 , 38 , 40 , 44 , 47 – 52 ].…”

Section: Resultsmentioning

confidence: 99%

Measurement properties, feasibility and clinical utility of the Doloplus-2 pain scale in older adults with cognitive impairment: a systematic review

et al. 2017

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BackgroundThe Doloplus-2 is a pain assessment scale for assessing pain in older adults with cognitive impairment. It is used in clinical practice and research. However, evidence for its measurement properties, feasibility and clinical utility remain incomplete. This systematic review synthesizes previous research on the measurement properties, feasibility and clinical utility of the scale.MethodWe conducted a systematic search in three databases (CINAHL, Medline and PsycINFO) for studies published in English, French, German, Dutch/Flemish or a Scandinavian language between 1990 and April 2017. We also reviewed the Doloplus-2 homepage and reference lists of included studies to supplement our search. Two reviewers independently reviewed titles and abstracts and performed the quality assessment and data abstraction.ResultsA total of 24 studies were included in this systematic review. The quality of the studies varied, but many lacked sufficient detail about the samples and response rates. The Doloplus-2 has been studied using diverse samples in a variety of settings; most study participants were in long-term care and in people with dementia. Sixteen studies addressed various aspects of the scale’s feasibility and clinical utility, but their results are limited and inconsistent across settings and samples. Support for the scale’s reliability, validity and responsiveness varied widely across the studies. Generally, the reliability coefficients reached acceptable benchmarks, but the evidence for different aspects of the scale’s validity and responsiveness was incomplete.ConclusionAdditional high-quality studies are warranted to determine in which populations of older adults with cognitive impairment the Doloplus-2 is reliable, valid and feasible. The ability of the Doloplus-2 to meaningfully quantify pain, measure treatment response and improve patient outcomes also needs further investigation.Trial registrationPROSPERO reg. no.: CRD42016049697 registered 20. Oct. 2016.Electronic supplementary materialThe online version of this article (10.1186/s12877-017-0643-9) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Measurement properties, feasibility and clinical utility of the Doloplus-2 pain scale in older adults with cognitive impairment: a systematic review

et al. 2017

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“…Full marketing authorisation for in‐hospital use of N 2 O/O 2 gas premixes in some European countries was already granted in 2001. Ever since then, the method has spread out and is successfully used, for example in elderly patients, paediatrics, obstetrics and gynaecology, recently in dental care, and even in emergency medical services for recovery of road accident victims . In 2006, its safety was proven in a large prospective study involving nearly 36 000 patients .…”

Section: Discussionmentioning

confidence: 99%

“…We therefore addressed in this study the question of whether an alternative analgesic method using the inhalation of an equimolar 50% N 2 O/O 2 gas premix would eventually be superior to the standard of care topical application of an eutectic mixture of 5% lidocaine/prilocaine. Simple handling of the gas premix, a rapid onset of its analgesic properties, and its widespread and successful use in many different indications appeared promising .…”

Section: Introductionmentioning

confidence: 99%

Analgesic efficacy of equimolar 50% nitrous oxide/oxygen gas premix (Kalinox®) as compared with a 5% eutectic mixture of lidocaine/prilocaine (EMLA®) in chronic leg ulcer debridement

Traber¹,

Held

Signer³

et al. 2016

International Wound Journal

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Chronic foot and leg ulcers are a common health problem worldwide. A mainstay of chronic ulcer therapy is sharp mechanical wound debridement requiring potent analgesia. In this prospective, controlled, single-centre, crossover design study, patients were assigned to either the administration of topical analgesia with 5% lidocaine/prilocaine cream or the inhalation of an analgesic 50% N O/O gas premix. Primary outcome parameter was level of pain at maximum wound depth during debridement as measured by a visual analogue scale. Secondary outcomes included level of pain after debridement, overall duration of treatment session, duration and completeness of debridement, and the patient's subjective perception of analgesic quality during debridement. Pain level increased from 0·60/0·94 (first/second debridement; baseline) to 1·76/2·50 (debridement) with 5% lidocaine/prilocaine and from 1·00/1·35 (baseline) to 3·95/3·29 (debridement) with 50% N O/O gas premix. Patient satisfaction was 90·48%/94·44% (first/second debridement) with topical 5% lidocaine/prilocaine analgesia and 90·48%/76·47% with the inhalation of 50% N O/O gas premix. Debridement was completed in a significantly higher percentage of 85·71%/88·89% (first/second debridement) with 5% lidocaine/prilocaine than with 50% N O/O gas premix (42·86%/58·82%) (odds ratio 6·7; P = 0·001). This study provides sound evidence that analgesia with topically administered 5% lidocaine/prilocaine cream is superior to the use of inhaled 50% N O/O gas premix in chronic leg ulcer debridement.

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“…L'utilisation du MEOPA est une méthode antalgique dont l'efficacité a été montrée, chez l'adulte, dans de nombreux domaines [2, 3,5,7,14,15,20,21]. Les effets indésirables du produit sont, la plupart du temps, bénins, mineurs et cessent dès l'arrêt d'administration du MEOPA [4,16,18]. Dans une large étude prospective française correspondant à 35 828 administrations de protoxyde d'azote, 1 581 (4,4 %) EI ont été rapportés, dont 27 (0,08 %) EI graves [16].…”

Section: Discussionunclassified

Prise en charge de la douleur au cours des procédures invasives en cancérologie : efficacité et acceptabilité du mélange inhalé 50 % N2O/O2 (MEOPA)

et al. 2010

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Tolerability of an Equimolar Mix of Nitrous Oxide and Oxygen during Painful Procedures in Very Elderly Patients

Abstract: This study shows the favourable tolerability of the equimolar N(2)O/O(2) mix in very elderly subjects, which makes this product a valuable tool for the management of acute pain in this age group.

Cited by 11 publications

References 22 publications

Measurement properties, feasibility and clinical utility of the Doloplus-2 pain scale in older adults with cognitive impairment: a systematic review

Measurement properties, feasibility and clinical utility of the Doloplus-2 pain scale in older adults with cognitive impairment: a systematic review

Analgesic efficacy of equimolar 50% nitrous oxide/oxygen gas premix (Kalinox®) as compared with a 5% eutectic mixture of lidocaine/prilocaine (EMLA®) in chronic leg ulcer debridement

Prise en charge de la douleur au cours des procédures invasives en cancérologie : efficacité et acceptabilité du mélange inhalé 50 % N2O/O2 (MEOPA)

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