Fixed 50:50 mixture of nitrous oxide and oxygen to reduce lumbar-puncture-induced pain: a randomized controlled trial. - Archive ouverte HAL
Article Dans Une Revue European Journal of Neurology Année : 2017

Fixed 50:50 mixture of nitrous oxide and oxygen to reduce lumbar-puncture-induced pain: a randomized controlled trial.

Résumé

Background and purpose Lumbar puncture (LP) has been frequently performed for more than a century. This procedure is still stressful and often painful. The aim of the study was to evaluate the efficacy of a fixed 50% nitrous oxide−oxygen mixture compared to placebo to reduce immediate procedural pain and anxiety during LP. Methods A randomized controlled trial was conducted involving adults who needed a cerebrospinal fluid analysis. Patients were randomly assigned to inhale either a fixed 50% nitrous oxide−oxygen mixture (50% N2O−O2) or medical air (22% O2−78% N2). Cutaneous application of a eutectic mixture of local anaesthetics was systematically done and all LPs were performed with pencil point 25G needles (20G introducer needle). The primary end-point was the maximal pain level felt by the patient during the procedure, the maximal anxiety level being a secondary outcome, both measured using a numerical rating scale (0–10). Results A total of 66 consecutive patients were randomized. The analysis was intention to treat. The maximal pain was 4.9 ± 2.7 for the 33 patients receiving air and 2.7 ± 2.7 for the 33 receiving 50% N2O−O2 (P = 0.002). Similarly, the maximal LP-induced anxiety was 4.5 ± 3.1 vs. 2.6 ± 2.6 (P = 0.009), respectively. The number needed to treat to avoid one patient undergoing significant pain (pain score ≥ 4/10) was 2.75. Body mass index >25 kg/m2 was significantly associated with higher pain intensity (P = 0.03). No serious adverse events were attributable to 50% N2O−O2 inhalation. Conclusions Inhalation of a fixed 50% N2O−O2 mixture is efficient to reduce LP-induced pain and anxiety.
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Dates et versions

hal-01547387 , version 1 (26-06-2017)

Identifiants

Citer

X. Moisset, M. A. Siaa, B. Pereira, F. Taithe, E. Dumont, et al.. Fixed 50:50 mixture of nitrous oxide and oxygen to reduce lumbar-puncture-induced pain: a randomized controlled trial. . European Journal of Neurology, 2017, 24, pp.46-52. ⟨10.1111/ene.13127⟩. ⟨hal-01547387⟩
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