Use of inhaled nitrous oxide for minor eyelid surgery: A placebo-controlled study

Bhatt, Rabindra; Child, V.; Kurli, Madhavi; Musadiq, M; Johns, Shelley A.; Stott, M.; Sandramouli, Soupramanien

doi:10.1076/orbi.22.3.177.15617

Cited by 6 publications

(6 citation statements)

References 7 publications

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“…A mixture of inhaled nitrous oxide and oxygen in equal proportions (Entonox) is an effective, short acting analgesic with few side effects that is widely used in obstetrics departments but which has also been used prior to a variety of minor surgical procedures (Bhatt et al, 2003;McIntyre, Dixon & Pantelides, 2003). We therefore prospectively evaluated the use of Entonox as an analgesic agent for patients undergoing BMAB.…”

Section: Introductionmentioning

confidence: 99%

Inhaled nitrous oxide (Entonox) as a short acting sedative during bone marrow examination

et al. 2006

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Bone marrow aspiration and biopsy is a procedure of central importance in the diagnosis of haematological disease and is one that can be safely performed in the outpatient clinic using only local anaesthesia. We evaluated the role of inhaled nitrous oxide (Entonox) as an adjuvant to local anaesthesia (LA) in patients requiring bone examination. We prospectively studied the role of Entonox in patients attending our outpatient department who required bone marrow examination. All patients received LA with injected 2% lignocaine but patients were then assigned to either LA alone or LA plus inhaled Entonox. Following the procedure patients were given a questionnaire and asked to score the discomfort associated with the procedure. Twenty-eight of 85 patients (33%) who received LA alone scored their pain as 3 (severe) compared with seven of 51 patients (14%) who received LA plus Entonox, P = 0.013. No adverse events were associated with Entonox use. Forty-three of the 51 patients who received Entonox stated that they would prefer to use this method of anaesthesia again. We conclude that inhaled Entonox is a useful adjuvant to local anaesthesia for patients undergoing bone marrow examination.

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Section: Introductionmentioning

confidence: 99%

Inhaled nitrous oxide (Entonox) as a short acting sedative during bone marrow examination

et al. 2006

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“…, N 2 O was utilized during the injection of lidocaine into the eyelid. Their placebo control study showed no significant difference in pain and an increase in complications with N 2 O 33 …”

Section: Resultsmentioning

confidence: 95%

“…Their placebo control study showed no significant difference in pain and an increase in complications with N 2 O. 33 In hysteroscopy, N 2 O has been perceived to be dangerous when used as the distending agent, 34,35 but has recently been evaluated in small studies as an anesthetic agent. Hong et al .…”

Section: Pharmacokineticsmentioning

confidence: 99%

Nitrous oxide as an adjunct in tumescent liposuction

Bird

Albert

2005

J of Cosmetic Dermatology

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“…She would likely be best treated under local anesthesia with sedation, not just nitrous oxide (Level II Evidence 43 ), or general anesthesia with upper lid blepharoplasty with skin excision and conservative muscle and fat management. Skin closure could be with sutures or glue (Level II Evidence 50 ).…”

Section: Suggested Treatment For Clinical Scenariomentioning

confidence: 99%

“…42 A prospective randomized controlled trial of nitrous oxide versus air for eyelid surgery by Bhatt et al showed no difference in diminishing the pain of injection of local anesthetics but did find more side effects in the nitrous oxide group (Level II Evidence). 43 In a 2009 double-blinded study in which lidocaine was injected in one eyelid and articaine was injected into the other eyelid, 22 of 30 patients found the articaine to be less painful (Level II Evidence). 44 Although it is more expensive, articaine has a safety profile similar to lidocaine.…”

Section: Evidence On Pain Managementmentioning

confidence: 99%

An Evidence-Based Approach to Blepharoplasty

Friedland

Lalonde

Rohrich

2010

Plastic and Reconstructive Surgery

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The Maintenance of Certification module series is designed to help the clinician structure his or her study in specific areas appropriate to his or her clinical practice. This article is prepared to accompany practice-based assessment of preoperative assessment, anesthesia, surgical treatment plan, perioperative management, and outcomes. In this format, the clinician is invited to compare his or her methods of patient assessment and treatment, outcomes, and complications, with authoritative, information-based references.This information base is then used for self-assessment and benchmarking in parts II and IV of the Maintenance of Certification process of the American Board of Plastic Surgery. This article is not intended to be an exhaustive treatise on the subject. Rather, it is designed to serve as a reference point for further in-depth study by review of the reference articles presented. (Plast. Reconstr. Surg. 126: 2222 CLINICAL SCENARIOA 56-year-old woman requests improvement in the appearance of her upper and lower eyelids. She had LASIK surgery 3 months earlier. She has ptosis of her left upper eyelid. What is the best evidence to guide you in the management of her condition? There is very little high level evidence in the blepharoplasty literature at this time. The age of evidence is just upon us, and objective measurement in aesthetic surgery is in its infancy. This article is a starting point where most of the evidence is level IV (case series) and level V (case reports or expert opinion). There is almost no level III evidence (retrospective comparative case series) and virtually no level II evidence (prospective comparative studies). It will be very difficult to create level I studies that are prospective randomized blinded controlled studies. Nevertheless, we have to start somewhere. One hundred years from now, there will be serious useful evidence-based studies in cosmetic plastic surgery, like looking from the top of a sky scraper. This is the first step at examining where we are in the basement of evidence based medicine in aesthetic blepharoplasty. METHODS FOR IDENTIFYING EVIDENCEA literature search of PubMed, Cumulative Index to Nursing and Allied Health Literature, and the Cochrane Library was performed to obtain the best available evidence on blepharoplasty, with emphasis on preoperative assessment, treatment, and outcomes. The following search terms were combined as appropriate, and PubMed MeSH terms were used when available: blepharoplasty, eyelid surgery, diagnosis, preoperative assessment, risk factors, smoking, diabetes mellitus, pulmonary embolism, venous thrombosis, dry eye syndromes, anticoagulants, DVT prophylaxis, antibiotic prophylaxis, anesthetics, premedication, surgical treatment plan, treatment, surgery, outcome, complications, postoperative complications, pain management, and analgesia. The initial search was limited to human studies that were published from 1999 to 2009 and indexed as metaanalyses, randomized controlled trials, clinical trials, or comparative studies. Very fe...

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Use of inhaled nitrous oxide for minor eyelid surgery: A placebo-controlled study

Abstract: Entonox has been used effectively in different specialties for pain relief. However, our study was unable to show this beneficial effect in relieving pain from local anaesthetic injections for minor eyelid surgery.

Cited by 6 publications

References 7 publications

Inhaled nitrous oxide (Entonox) as a short acting sedative during bone marrow examination

Inhaled nitrous oxide (Entonox) as a short acting sedative during bone marrow examination

Nitrous oxide as an adjunct in tumescent liposuction

An Evidence-Based Approach to Blepharoplasty

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