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Nitrous oxide procedural sedation in non-fasting pediatric patients undergoing minor surgery: a 12-year experience with 1,058 patients

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Abstract

Background

Nitrous oxide’s safety and efficacy for minor procedures is an alternative to general anesthesia, complex sedation protocols, or local anesthetic alone.

Methods

A retrospective review of prospectively-collected data (2000–2012) identified 1,058 children who received single-agent nitrous oxide for minor surgery.

Results

Children (n = 1,058, male 42 %, female 58 %) aged 1–23 years (mean = 9.8 + 5.1 years) were identified. Only nine children (0.9 %) fasted. ASA status was I–II in 1,053 (99.5 %) of patients; five (0.5 %) had an ASA III. There were no major complications (desaturation, emergency admission, apnea, airway obstruction, bradycardia) or aborted procedures. Minor complications occurred in 1.8 %; there was no association between these complications and ASA, fasting status or maximum nitrous oxide percentage administered (all p > 0.05). Post-operatively, 98 % of patients denied getting an injection. Eighty-two percent reported mild or no procedural pain.

Conclusion

This is the longest reported study using non-anesthesiologist-administered nitrous oxide as a single-agent for minor surgical procedures. The technique provides safe sedation and excellent amnesia, allowing pain and anxiety-reduced surgery with no fasting or postoperative monitoring.

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Conflict of interest

The authors have no conflict of interest to disclose.

Author information

Authors and Affiliations

  1. Department of Pediatric Surgery, Miami Children’s Hospital, 3200 SW 60 Court, Suite 201, Miami, FL, 33155, USA

    Raquel Pasarón, Cathy Burnweit, Jeannette Zerpa, Leopoldo Malvezzi, Colin Knight & Carmen Ramos-Irizarry

  2. Nemours Children’s Hospital, 1717 S Orange Ave Suite 100, Orlando, FL, 32806, USA

    Tina Shapiro

  3. Barry University, 11300 NE 2nd Avenue, Miami, FL, 33161, USA

    Evelio Velis

Authors
  1. Raquel Pasarón
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  2. Cathy Burnweit
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  3. Jeannette Zerpa
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  4. Leopoldo Malvezzi
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  5. Colin Knight
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  6. Tina Shapiro
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  7. Carmen Ramos-Irizarry
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  8. Evelio Velis
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Correspondence to Raquel Pasarón.

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Pasarón, R., Burnweit, C., Zerpa, J. et al. Nitrous oxide procedural sedation in non-fasting pediatric patients undergoing minor surgery: a 12-year experience with 1,058 patients. Pediatr Surg Int 31, 173–180 (2015). https://doi.org/10.1007/s00383-014-3608-5

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  • DOI: https://doi.org/10.1007/s00383-014-3608-5

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