Nitrous Oxide sedation for intra-articular injection in juvenile idiopathic arthritis

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Nitrous Oxide sedation for intra-articular injection in juvenile idiopathic

arthritis

http://www.ped-rheum.com/content/6/1/1/abstract

Pediatric Rheumatology 2008, 6:1doi:10.1186/1546-0096-6-1

Published:15 January 2008

Yosef Uziel , Gil Chapnick , Michal Rothschild , Tsivia Tauber , ph

Press , Liora Harel and Philip J Hashkes

Abstract (provisional)

Background

Intra-articular corticosteroid injection in juvenile idiopathic arthritis

(JIA) is often associated with anxiety and pain. Recent reports advocate the

use of nitrous oxide (NO), a volatile gas with analgesic, anxiolytic and

sedative properties.

Objective

To prospectively evaluate the effectiveness and safety of NO analgesia for

intra-articular corticosteroid injection in JIA, and to assess patients and

staff satisfaction with the treatment.

Methods

NO was administered to JIA patients scheduled for joint injection. The

patient, parent, physician and nurse completed visual-analog scores (VAS)

(0-10, 10 is worst) for pain, and a 5-point Likert satisfaction scale (5 is

best). Change in heart rate (HR) during the procedure was recorded in order

to examine physiologic response to pain and stress. Patient's behavior and

adverse reactions were recorded.

Results

54 procedures (72 joints) were performed, 41 females, 13 males; 39 Jewish,

13 Arab; mean age was 12.2 +/- 4.7 year. The median VAS pain score for

patients, parents, physicians and nurses was 3. The HR increased [greater

than or equal to]15% in 10 patients. They had higher VAS scores as evaluated

by the staff. The median satisfaction level of the parents and staff was 3.0

and 5.0 respectively. Adverse reactions were mild.

Conclusions

NO provides effective and safe sedation for JIA children undergoing

intra-articular injections.