SELF-ADMINISTERED NITROUS-OXIDE ANALGESIA FOR PEDIATRIC FRACTURE REDUCTIONS

We prospectively studied the efficacy and safety of self-administered nitrous oxide analgesia for 54 children undergoing closed reductions o f fractures in the emergency department. No child was excluded from en try into the study because of fracture type. Nitrous oxide was the sol e source of analgesia. The average Children's Hospital of Eastern Onta rio pain score (CHEOPS) rated by the emergency medicine physician obse rving the reduction was 9.1 (range 6-13). Ninety-one percent of childr en obtained an analgesic effect; however, 46% of children had a CHEOPS score of greater-than-or-equal-to 10, indicating significant pain. A statistically significantly higher proportion of failures using nitrou s-oxide analgesia occurred in patients with completely displaced radiu s/ulna fractures (p = 0.027). No complications such as vomiting, respi ratory depression, or a change in oxygen saturation resulted from the use of nitrous oxide.