Effectiveness of nitrous oxide sedation for otolaryngologic examination in the outpatient clinic in uncooperative children

Int J Pediatr Otorhinolaryngol. 2022 Nov:162:111328. doi: 10.1016/j.ijporl.2022.111328. Epub 2022 Sep 28.

Abstract

Objectives: The aim of this study is to investigate the efficacy of equimolar mixture of 50% nitrous oxide and oxygen (EMONO) to obtain conscious sedation for otolaryngologic examinations and minor Ear-Nose-Throat (ENT) procedures in children with or without comorbidities.

Methods: Retrospective analysis of patient records from all children who were uncooperative during routine ENT examination, and therefore underwent otomicroscopic examinations and/or minor ENT procedures sedated with EMONO in the outpatient ENT clinic. The following data were collected: patients characteristics, sedative effect, analgesic effect and adverse effects. Patients were divided into three subgroups: 1) no relevant comorbidities, 2) Down Syndrome and 3) other causes of behavioural problems or developmental delay.

Results: Data were analyzed for 99 patients (170 procedures). Seven procedures failed. A good to excellent sedative and analgesic effect was obtained in most patients without a difference between subgroups. Minor and transient side effects were encountered in one third (34%) of the patients.

Conclusions: EMONO is an effective agent to achieve conscious sedation and to perform ENT examinations or minor procedures in otherwise uncooperative children with or without developmental delay.

Keywords: Conscious sedation; Nitrous oxide sedation; Pediatric otolaryngology.

MeSH terms

  • Ambulatory Care Facilities
  • Analgesics
  • Anesthetics, Inhalation* / adverse effects
  • Child
  • Conscious Sedation / adverse effects
  • Conscious Sedation / methods
  • Humans
  • Hypnotics and Sedatives / adverse effects
  • Nitrous Oxide* / adverse effects
  • Oxygen
  • Pharynx
  • Retrospective Studies

Substances

  • Analgesics
  • Anesthetics, Inhalation
  • Hypnotics and Sedatives
  • Nitrous Oxide
  • Oxygen