scholarly journals Pain and Stress Response during Intravenous Access in Children with Congenital Adrenal Hyperplasia: Effects of EMLA and Nitrous Oxide Treatment

2017 ◽  
Vol 2017 ◽  
pp. 1-7
Author(s):  
K. Ekbom
Keyword(s):  
Heart Rate ◽  
Nitrous Oxide ◽  
Congenital Adrenal Hyperplasia ◽  
Adrenal Hyperplasia ◽  
Intravenous Access ◽  
Glucose Levels ◽  
Pain Scores ◽  
17 Hydroxyprogesterone ◽  
Children's Pain

Background. Congenital adrenal hyperplasia (CAH) is an endocrine condition that requires regularly blood samples for optimal treatment. The management of CAH in children is complex when intravenous access is one of the most stressful procedures for children. The purpose of this pilot study was to investigate the effects of nitrous oxide inhalation (N2O) in combination with cutaneous application of local anesthetics (EMLA) for improving intravenous access in children with CAH. Method. Ten children (7–14 years) were studied. The children received two intravenous procedures: one with EMLA and one with EMLA + N2O. The order of priority was randomized. The outcomes were the children’s pain experience (0–10) and an evaluation of satisfaction (1–5) after the procedure. Heart rate, blood pressure, saturation, and analyses of 17-hydroxyprogesterone (17-OHP), norepinephrine, and glucose were analyzed. Results. Higher pain scores, heart rate, and glucose levels were reported after EMLA, compared to EMLA + N2O, but 17-OHP levels remained unchanged. The children’s satisfaction with the intravenous procedure was more positive for EMLA + N2O. Conclusions. EMLA + N2O offers the possibility of improving the intravenous procedure for anxious children with CAH. Although the quality of care was better with N2O treatment, it was not possible to demonstrate that this is a prerequisite for valid 17-OHP measurements.

Psychosexual Quality of Life in Adult Intersexuality: The Example of Congenital Adrenal Hyperplasia (CAH)

2000 ◽  
pp. 200-208 ◽  
Author(s):  
Heino F. L. Meyer-Bahlburg ◽  
Sonia Gidwani ◽  
Ralf W. Dittmann ◽  
Curtis Dolezal ◽  
Susan W. Baker ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Congenital Adrenal Hyperplasia ◽  
Adrenal Hyperplasia

Screening for Congenital Adrenal Hyperplasia: The Delfia Screening Test Overestimates Serum 17-Hydroxyprogesterone in Preterm Infants

PEDIATRICS ◽  
1996 ◽  
Vol 97 (1) ◽  
pp. 100-102 ◽  
Author(s):  
Saad Al Saedi ◽  
Heather Dean ◽  
William Dent ◽  
Elizabeth Stockl ◽  
Catherine Cronin
Keyword(s):  
Congenital Adrenal Hyperplasia ◽  
Preterm Infants ◽  
Gestational Age ◽  
Adrenal Hyperplasia ◽  
Blood Spots ◽  
Healthy Infants ◽  
Extraction Step ◽  
Postconceptional Age ◽  
17 Hydroxyprogesterone ◽  
Over Time

Objective. To compare 17-hydroxyprogesterone (17-OHP) levels measured by quantitative serum radioimmunoassay (RIA), including an extraction step, and by screening fluoroimmnoassay (FIA) on blood spots in preterm infants. Methods. Subjects were 39 healthy infants born at less than 31 weeks' gestational age. Each infant had weekly blood sampling, and RIA and FIA were performed on each sample. Results. Two hundred twenty-seven samples were taken at 28 to 41 weeks' postconceptional age. Mean ± SD 17-OHP measured by RIA was 11.4 ± 11.1 nmol/L (0.4 ± 0.4 µg/dL), and decreased over time. Mean ± SD 17-OHP measured by FIA was 38.96 ± 37.3 nmol/L, greater than 17-OHP (RIA). Log(δFIA-RIA) was inversely related to postconceptional age (R2 = .39). Conclusion. Screening FIA of blood spots overestimates levels of 17-OHP in preterm infants and should not be used to determine the likelthood of congenital adrenal hyperplasia in this population. We have abandoned FIA screening for congenital adrenal hyperplasia in infants weiging less than 1500 g.

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