Effect of nitrous oxide on fentanyl consumption in burned patients undergoing dressing change
Background and objectives: Thermal injuries and injured areas management are important causes of pain in burned patients, requiring that these patients are constantly undergoing general anesthesia for dressing change. Nitrous oxide (N2O) has analgesic and sedative properties; it is easy to use and w...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2016-01-01
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| Series: | Brazilian Journal of Anesthesiology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0104001414002309 |
| _version_ | 1797998322913378304 |
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| author | Arthur Halley Barbosa do Vale Rogério Luiz da Rocha Videira David Souza Gomez Maria José Carvalho Carmona Sara Yume Tsuchie Cláudia Flório Matheus Fachini Vane Irimar de Paula Posso |
| author_facet | Arthur Halley Barbosa do Vale Rogério Luiz da Rocha Videira David Souza Gomez Maria José Carvalho Carmona Sara Yume Tsuchie Cláudia Flório Matheus Fachini Vane Irimar de Paula Posso |
| author_sort | Arthur Halley Barbosa do Vale |
| collection | DOAJ |
| description | Background and objectives: Thermal injuries and injured areas management are important causes of pain in burned patients, requiring that these patients are constantly undergoing general anesthesia for dressing change. Nitrous oxide (N2O) has analgesic and sedative properties; it is easy to use and widely available. Thus, the aim of this study was to evaluate the analgesic effect of N2O combined with fentanyl in burned patients during dressing change. Method: After approval by the institutional Ethics Committee, 15 adult burned patients requiring daily dressing change were evaluated. Patient analgesia was controlled with fentanyl 0.0005% administered by intravenous pump infusion on-demand. Randomly, in one of the days a mixture of 65% N2O in oxygen (O2) was associated via mask, with a flow of 10 L/min (N2O group) and on the other day only O2 under the same flow (control group). Results: No significant pain reduction was seen in N2O group compared to control group. VAS score before dressing change was 4.07 and 3.4, respectively, in N2O and control groups. Regarding pain at the end of the dressing, patients in N2O group reported pain severity of 2.8; while the control group reported 2.87. There was no significant difference in fentanyl consumption in both groups. Conclusions: The association of N2O was not effective in reducing opioid consumption during dressing changes. Resumo: Justificativa e objetivos: Os ferimentos térmicos e a manipulação das áreas lesadas são causas importantes de dor em pacientes vítimas de queimaduras, necessitando que estes pacientes sejam constantemente submetidos a anestesias gerais para a troca do curativo. O óxido nitroso (N2O) tem propriedades analgésicas e sedativas, sendo capaz de fácil utilização e de ampla disponibilidade. Com isto, objetivou-se avaliar o efeito analgésico da administração de N2O associado ao fentanil em pacientes queimados, durante a troca de curativo. Método: Após aprovação pela comissão de ética institucional, foram avaliados 15 pacientes adultos, vítimas de queimaduras com necessidade de troca diária de curativo. A analgesia do paciente foi controlada pelo uso de fentanil 0,0005% administrado por bomba de infusão sob demanda, intravenosa. De maneira aleatória, em um dos dias foi associada mistura de N2O a 65% em oxigênio (O2) sob máscara com fluxo de 10 L/min (grupo N2O) e no outro dia apenas O2 sob o mesmo fluxo (grupo controle). Resultados: Não se observou diminuição significativa da dor no grupo N2O em relação ao grupo controle. A dor na EAV antes da troca do curativo foi de 4,07 e 3,4; respectivamente nos grupos N2O e controle. Quanto à dor ao término da troca de curativo, os pacientes do grupo N2O referiram dor intensidade 2,8; enquanto no grupo controle foi de 2,87. Não houve diferença significativa de consumo de fentanil em ambos os grupos. Conclusões: A associação de N2O não foi eficaz na redução no consumo de opióides durante a troca de curativos. Keywords: Pain, Nitrous oxide, Burns, Debridement, Palavras-chave: Dor, Óxido nitroso, Burns, Desbridamento |
| first_indexed | 2024-04-11T10:46:51Z |
| format | Article |
| id | doaj.art-7a0672931a6341c7affb2fbb4230b4eb |
| institution | Directory Open Access Journal |
| issn | 0104-0014 |
| language | English |
| last_indexed | 2024-04-11T10:46:51Z |
| publishDate | 2016-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Anesthesiology |
| spelling | doaj.art-7a0672931a6341c7affb2fbb4230b4eb2022-12-22T04:29:01ZengElsevierBrazilian Journal of Anesthesiology0104-00142016-01-01661711Effect of nitrous oxide on fentanyl consumption in burned patients undergoing dressing changeArthur Halley Barbosa do Vale0Rogério Luiz da Rocha Videira1David Souza Gomez2Maria José Carvalho Carmona3Sara Yume Tsuchie4Cláudia Flório5Matheus Fachini Vane6Irimar de Paula Posso7Corresponding author.; Discipline of Anesthesiology, Faculdade de Medicina, Universidade de São Paulo, Instituto Central do HCFMUSP, São Paulo, SP, BrazilDiscipline of Anesthesiology, Faculdade de Medicina, Universidade de São Paulo, Instituto Central do HCFMUSP, São Paulo, SP, BrazilDiscipline of Anesthesiology, Faculdade de Medicina, Universidade de São Paulo, Instituto Central do HCFMUSP, São Paulo, SP, BrazilDiscipline of Anesthesiology, Faculdade de Medicina, Universidade de São Paulo, Instituto Central do HCFMUSP, São Paulo, SP, BrazilDiscipline of Anesthesiology, Faculdade de Medicina, Universidade de São Paulo, Instituto Central do HCFMUSP, São Paulo, SP, BrazilDiscipline of Anesthesiology, Faculdade de Medicina, Universidade de São Paulo, Instituto Central do HCFMUSP, São Paulo, SP, BrazilDiscipline of Anesthesiology, Faculdade de Medicina, Universidade de São Paulo, Instituto Central do HCFMUSP, São Paulo, SP, BrazilDiscipline of Anesthesiology, Faculdade de Medicina, Universidade de São Paulo, Instituto Central do HCFMUSP, São Paulo, SP, BrazilBackground and objectives: Thermal injuries and injured areas management are important causes of pain in burned patients, requiring that these patients are constantly undergoing general anesthesia for dressing change. Nitrous oxide (N2O) has analgesic and sedative properties; it is easy to use and widely available. Thus, the aim of this study was to evaluate the analgesic effect of N2O combined with fentanyl in burned patients during dressing change. Method: After approval by the institutional Ethics Committee, 15 adult burned patients requiring daily dressing change were evaluated. Patient analgesia was controlled with fentanyl 0.0005% administered by intravenous pump infusion on-demand. Randomly, in one of the days a mixture of 65% N2O in oxygen (O2) was associated via mask, with a flow of 10 L/min (N2O group) and on the other day only O2 under the same flow (control group). Results: No significant pain reduction was seen in N2O group compared to control group. VAS score before dressing change was 4.07 and 3.4, respectively, in N2O and control groups. Regarding pain at the end of the dressing, patients in N2O group reported pain severity of 2.8; while the control group reported 2.87. There was no significant difference in fentanyl consumption in both groups. Conclusions: The association of N2O was not effective in reducing opioid consumption during dressing changes. Resumo: Justificativa e objetivos: Os ferimentos térmicos e a manipulação das áreas lesadas são causas importantes de dor em pacientes vítimas de queimaduras, necessitando que estes pacientes sejam constantemente submetidos a anestesias gerais para a troca do curativo. O óxido nitroso (N2O) tem propriedades analgésicas e sedativas, sendo capaz de fácil utilização e de ampla disponibilidade. Com isto, objetivou-se avaliar o efeito analgésico da administração de N2O associado ao fentanil em pacientes queimados, durante a troca de curativo. Método: Após aprovação pela comissão de ética institucional, foram avaliados 15 pacientes adultos, vítimas de queimaduras com necessidade de troca diária de curativo. A analgesia do paciente foi controlada pelo uso de fentanil 0,0005% administrado por bomba de infusão sob demanda, intravenosa. De maneira aleatória, em um dos dias foi associada mistura de N2O a 65% em oxigênio (O2) sob máscara com fluxo de 10 L/min (grupo N2O) e no outro dia apenas O2 sob o mesmo fluxo (grupo controle). Resultados: Não se observou diminuição significativa da dor no grupo N2O em relação ao grupo controle. A dor na EAV antes da troca do curativo foi de 4,07 e 3,4; respectivamente nos grupos N2O e controle. Quanto à dor ao término da troca de curativo, os pacientes do grupo N2O referiram dor intensidade 2,8; enquanto no grupo controle foi de 2,87. Não houve diferença significativa de consumo de fentanil em ambos os grupos. Conclusões: A associação de N2O não foi eficaz na redução no consumo de opióides durante a troca de curativos. Keywords: Pain, Nitrous oxide, Burns, Debridement, Palavras-chave: Dor, Óxido nitroso, Burns, Desbridamentohttp://www.sciencedirect.com/science/article/pii/S0104001414002309 |
| spellingShingle | Arthur Halley Barbosa do Vale Rogério Luiz da Rocha Videira David Souza Gomez Maria José Carvalho Carmona Sara Yume Tsuchie Cláudia Flório Matheus Fachini Vane Irimar de Paula Posso Effect of nitrous oxide on fentanyl consumption in burned patients undergoing dressing change Brazilian Journal of Anesthesiology |
| title | Effect of nitrous oxide on fentanyl consumption in burned patients undergoing dressing change |
| title_full | Effect of nitrous oxide on fentanyl consumption in burned patients undergoing dressing change |
| title_fullStr | Effect of nitrous oxide on fentanyl consumption in burned patients undergoing dressing change |
| title_full_unstemmed | Effect of nitrous oxide on fentanyl consumption in burned patients undergoing dressing change |
| title_short | Effect of nitrous oxide on fentanyl consumption in burned patients undergoing dressing change |
| title_sort | effect of nitrous oxide on fentanyl consumption in burned patients undergoing dressing change |
| url | http://www.sciencedirect.com/science/article/pii/S0104001414002309 |
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