Controlo da dor em pediatria - a experiência de utilização da mistura equimolar de protóxido de azoto

Abstract

Introduction: Nursing interventions to control pain in pediatrics are essential to ensure the provision of quality-of-care. The timely implementation of non-pharmacological and pharmacological measures for the management and control of pain in children/young people has been an area of investment in order to promote an atraumatic hospitalization experience. Aim: In this article we intend to share the experience of using the Equimolar Mixture of Nitrogen Protoxide and Oxygen (MEOPA) in a Pediatric Inpatient Service, of a Level II Hospital (medical-surgical), highlighting its implementation process and integration in the professional context. Materials and Methods: Bibliographic research was used and the practices associated with the seven years of experience (2013 to 2019) with MEOPA were studied, including the analysis of: consumption of gas bottles, nurse intervention in the administration of MEOPA, and a convenience sample of 54 children/young people subjected to the administration of MEOPA during hospitalization. Results: The consumption of MEOPA bottles has grown over the years, being characterized by being a safe, effective and easy-to-use resource. The sample of 54 children/young people studied consisted of 61% male, the median age was 8 years (interquartile range I25-75 = [5; 13.5], range = [2; 17] years). The procedures that motivated the use of MEOPA consisted of: peripheral venous catheterization (74%), blood collection (24%) and exams (2%). In 86% of children/young people, pain before and after the procedure was rated zero. About 14% of children/young people had previous pain, with a median of 3.5 on the pain scale (I25-75 = [2; 4.75], range = [2; 7]), and after performing the procedure the rated pain had a median of 1 (I25-75 = [1], range = [0; 1]). Regarding the time of administration of MEOPA, 61% of cases corresponded to a time less than or equal to 10 minutes, 31% between 10 to 20 minutes, 6% between 20 to 30 minutes and 2% between 30 to 40 minutes. Side effects occurred in 2%, with a sensation of lipothymia, with rapid resolution. Conclusion: The administration of MEOPA, as a strategy to minimize the pain and anxiety associated with procedures, is considered as a measure that reflects an atraumatic approach and mirrors a pediatric care philosophy based on respect for the Rights of Hospitalized Children.