Pediatric Sedation and Analgesia Outside the Operating Room: Combining Intranasal Fentanyl and Inhaled Nitrous Oxide.

Hoeffe, Julia; Vogel, Regina G; Ammann, Roland A (2022). Pediatric Sedation and Analgesia Outside the Operating Room: Combining Intranasal Fentanyl and Inhaled Nitrous Oxide. The journal of pediatric pharmacology and therapeutics, 27(5), pp. 436-442. The Pediatric Pharmacy Association 10.5863/1551-6776-27.5.436

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OBJECTIVE

Combining intranasal fentanyl (IN FENT) with inhaled nitrous oxide (N2O) seems to have good properties for pediatric procedural sedation and analgesia (PSA). This study aims to assess the side effect rate of the combined use of IN FENT and N2O.

METHODS

We performed a retrospective, single-center study. Patients treated in either the pediatric emergency department (PED) or the pediatric surgery outpatient clinic (PSOC) were included, if they received PSA with IN FENT and nitrous oxide with 50% oxygen (N2O 50%).

RESULTS

Three hundred seventy-five patients were included over a period of 4 years. Median age was 9.4 years (range, 3.1 to 15.9) and 39% of patients were female. Overall side effect rate was 30% (114 patients). Most frequent was dizziness (n = 63, 17%; 95% CI, 13-21), followed by nausea (n = 23, 6%; 95% CI, 4-9) and emesis (n = 14, 4%; 95% CI, 2-6), with 35 patients having either nausea and/or emesis (9%; 95% CI, 7-13). No serious side effects were recorded (0%; 95% CI, 0-0.1). Of 298 patients with information regarding satisfaction, 280 patients would like the same sedation for a similar procedure in the future (94%; 95% CI, 90-96). We found no relation between previously described risk factors and emesis and/or nausea.

CONCLUSIONS

N2O 50% combined with IN FENT can be recommended as an effective and safe treatment in the PED and the PSOC. While the side effect rate, primarily dizziness, nausea and emesis was substantial, antiemetic prophylaxis is not indicated owing to the overall low incidence of nausea and emesis.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine 04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine > Notfallzentrum für Kinder und Jugendliche
UniBE Contributor:	Höffe, Julia, Ammann, Roland
Subjects:	600 Technology > 610 Medicine & health
ISSN:	1551-6776
Publisher:	The Pediatric Pharmacy Association
Language:	English
Submitter:	Anette van Dorland
Date Deposited:	20 Jul 2022 12:31
Last Modified:	05 Dec 2022 16:21
Publisher DOI:	10.5863/1551-6776-27.5.436
PubMed ID:	35845565
Uncontrolled Keywords:	analgesia conscious sedation drug-related side effects fentanyl intranasal administration nitrous oxide pediatrics
URI:	https://boris.unibe.ch/id/eprint/171414