Effectiveness of nitrous oxide sedation for otolaryngologic examination in the outpatient clinic in uncooperative children.

Abstract

The aim of this study is to investigate the efficacy of equimolar mixture of 50% nitrous oxide and oxygen (EMONO) to obtain conscious sedation for otolaryngologic examinations and minor Ear-Nose-Throat (ENT) procedures in children with or without comorbidities. Retrospective analysis of patient records from all children who were uncooperative during routine ENT examination, and therefore underwent otomicroscopic examinations and/or minor ENT procedures sedated with EMONO in the outpatient ENT clinic. The following data were collected: patients characteristics, sedative effect, analgesic effect and adverse effects. Patients were divided into three subgroups: 1) no relevant comorbidities, 2) Down Syndrome and 3) other causes of behavioural problems or developmental delay. Data were analyzed for 99 patients (170 procedures). Seven procedures failed. A good to excellent sedative and analgesic effect was obtained in most patients without a difference between subgroups. Minor and transient side effects were encountered in one third (34%) of the patients. EMONO is an effective agent to achieve conscious sedation and to perform ENT examinations or minor procedures in otherwise uncooperative children with or without developmental delay.