Health aspects among personnel working with nitrous oxide for procedural pain management in children

Background - 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. Objective - 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. Methods - 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. Results - 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. Conclusions - 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.

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Pain and anxiety experiences of South African adult burn injury patients during physiotherapy management

South African Journal of Physiotherapy ◽

10.4102/sajp.v66i1.56 ◽

2010 ◽

Vol 66 (1) ◽

Cited By ~ 1

Author(s):

L.D. Morris ◽

Q.A. Louw

Keyword(s):

Pain Management ◽

Side Effects ◽

South African ◽

Functional Outcomes ◽

Burn Injury ◽

Current Situation ◽

Procedural Pain ◽

Short Report ◽

Burn Unit ◽

Effective Adjunct

A dequate management of procedural pain during physiotherapy management plays an important role in building a trusting relationship betweenthe burn victim and the physiotherapist, and in ensuring desirable functional outcomes. However, the burn pain management regimens currently utilized inburn units, primarily consist of traditional pharmacologic analgesics which areassociated with numerous side-effects and alone are often reported as inadequateto alleviate procedural pain, warranting safer and effective adjunct therapies.Prior to the introduction and implementation of adjunct therapies into a developing world, it is imperative that the current situation in a burn unit, in terms of whether or not the pain management regimens in place are adequate, is first assessed, due to cost concerns. The following short report exemplifies the pain and anxiety experiences of a small number of burn injury patients during physiotherapy at the Tygerberg Hospital adult burn unit, South A frica. It was hypothesized that the results of this study would underpin whether adult burn injury patients in a developing countryrequire adjunct therapies during physiotherapy management to supplement traditional pharmacologic analgesics inmanaging their procedural pain and subsequent anxiety.

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Massage therapy for paediatric procedural pain: A rapid review

Paediatrics & Child Health ◽

10.1093/pch/pxz133 ◽

2019 ◽

Author(s):

Kylie Bernstein ◽

Mohammad Karkhaneh ◽

Liliane Zorzela ◽

Hsing Jou ◽

Sunita Vohra

Keyword(s):

Pain Management ◽

Standard Care ◽

Complementary Therapies ◽

Massage Therapy ◽

Risk Of Bias ◽

Rapid Review ◽

Secondary Outcome ◽

Procedural Pain ◽

Randomized Controlled ◽

Pain Scales

Abstract Background Pain is a common paediatric problem, and procedural pain, in particular, can be difficult to manage. Complementary therapies are often sought for pain management, including massage therapy (MT). We assessed the evidence for use of MT for acute procedural pain management in children. Methods We searched five main databases for (i) primary studies in English, (ii) included children 0 to 18 years of age, (iii) compared MT for procedural pain management to standard care alone or placebo, and (iv) measured pain as the primary or secondary outcome. The data were extracted by one author and verified by a second author. Randomized controlled trials were evaluated using the Cochrane Risk of Bias tool. Results Eleven paediatric trials of procedural pain in neonatal, burn, and oncology populations, a total of 771 participants, were identified. Eight reported statistically significant reductions in pain after MT compared to standard care. Pain was measured using validated pain scales, or physiologic indicators. The studies were heterogeneous in population, techniques, and outcome measures used. No adverse events associated with MT were identified. Conclusion MT may be an effective nonpharmacologic adjunct for management of procedural pain in children.

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