| Learning Objective #1: List three advantages of nitrous oxide analgesia as compared to conscious sedation | |||
| Learning Objective #2: Identify three effects of nitrous oxide on the pediatric patient |
Objective: Children undergoing minor surgical procedures, while usually not requiring general anesthesia, need control of pain, anxiety, and motion. The most upsetting event for children is generally the local injection. Little research has been done on alternatives to alleviating this fear (Whaley & Wong, 1999). Nitrous oxide analgesia may be utilized in place of conscious sedation safely, cost-effectively, and with certain advantages. The analgesia is administered by a sedation-certified nurse practitioner without an anesthesiologist present, no loss of protective airway reflexes occurs, no fasting is required, nor post-procedure monitoring. This study examined safety & efficacy of nitrous oxide in children undergoing outpatient surgical procedures.
Design: Descriptive exploratory study.
Sample: From 2000-2002, data was collected on 150 children who received nitrous oxide analgesia for minor surgical procedures.
Methods: Pediatric patients were given nitrous oxide (</=50%) by a nurse practitioner instead of general anesthesia, sedation, or local anesthetic alone. Children used the Wong-Baker Faces Scale (0-5) to score pain at different intervals (pre-procedure, @injection, intra-procedure, & post-procedure).
Findings: Of 150 children, 5 were uncooperative & didn't participate; 2 were too young to score pain. 145 children ages 1-20 years (M=9.83 +/- 4.92 years) successfully underwent procedures (58 cyst/nevus excisions, 49 abscess drainages, 38 other) using nitrous. Pre/post-procedure pain scores were significantly higher in abscess group (p<.0001). Intra-procedure pain scores were reported as M<1 in all groups, with parents citing 100% satisfaction with technique. Of 129 children receiving local anesthesia, 107 (84%) had no recall of injections. Complications were limited to four (two experienced nausea and two vomited) but all resolved without interrupting the procedure.
Conclusion: Nitrous oxide analgesia is an efficacious alternative to conscious sedation or general anesthesia for minor pediatric surgical procedures.
Nursing Implications: A policy was instituted @ MCH for dispensing nitrous oxide by credentialed ARNPs without an anesthesiologist.
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Back to 14th International Nursing Research Congress
Sigma Theta Tau International
10-12 July 2003