Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-20T04:55:53.105Z Has data issue: false hasContentIssue false
  • English
  • Français

An Evaluation of Nitrous Oxide Analgesia During Transcutaneous Pacing

Published online by Cambridge University Press:  28 June 2012

Richard M. Kaplan ,
Michael B. Heller ,
John McPherson  and
Paul M. Paris
Richard M. Kaplan
Affiliation:
University of Pittsburgh School of Medicine, Division of Emergency Medicine and the Center for Emergency Medicine of Western Pennsylvania
Michael B. Heller*
Affiliation:
University of Pittsburgh School of Medicine, Division of Emergency Medicine and the Center for Emergency Medicine of Western Pennsylvania
John McPherson
Affiliation:
University of Pittsburgh School of Medicine, Division of Emergency Medicine and the Center for Emergency Medicine of Western Pennsylvania
Paul M. Paris
Affiliation:
University of Pittsburgh School of Medicine, Division of Emergency Medicine and the Center for Emergency Medicine of Western Pennsylvania
*
Michael B. Heller MD, FACEP, 230 McKee Place, Suite 500, Pittsburgh, PA 15213, USA (412) 578-3200
Get access Rights & Permissions [Opens in a new window]

Abstract

Transcutaneous cardiac pacing (TCP) is a promisingprehospital intervention, but there are little data available regarding protocols to improve patient tolerance to TCP. A 50:50 nitrous oxide:oxygen analgesic mixture aho is a commonly employed prehospital intervention. In this randomized, prospective study, we compared the discomfort experienced by 18 healthy subjects when paced in two triah at the capture threshold: one following breathing of a 50:50 nitrous oxide:oxygen mixture; and the second breathing only room air. Discomfort was rated on an analog scale from 1 (minimal discomfort) to 10 (severe pain). Of the 18 subjects, 15 (83%) reported that nitrous oxide improved the tolerance to pacing at capture threshold. The median pain scores at capture threshold in the nitrous oxide and room air group were 3.8 and 5.0 respectively (P<.05). Nine of the subjects tolerated TCP for the maximum allotted time of 30 seconds in each trial; six tolerated TCP for a longer time period in the nitrous oxide trial; three tolerated TCP longer in the room air trial. These data suggest that inhalation of a 50:50 nitrous oxide:oxygen mixture may improve tolerance to TCP in the conscious patient.

Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 5 , Issue 2 , June 1990 , pp. 145 - 148
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1990

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Zoll, PM, Linethal, AJ, Norman, LR: Treatment of Stokes-Adams disease by external electric stimulation of the heart. Circulation 1954;9:482–493.CrossRefGoogle ScholarPubMed
2. Zoll, PM, Zoll, RH, Belgard, AH: External noninvasive electric stimulation of the heart. Crit Care Med 1981;9:393–394.CrossRefGoogle ScholarPubMed
3. Zoll, PM: Noninvasive temporary cardiac pacing. J Electrophysiology 1987; 1 (2): 156–161.Google Scholar
4. Falk, RH: External Cardiac Pacing, in Modern Cardiac Pacing, Barold, SS, ed, Mount Kisco NY, Futura Publishing 1985; pp. 775–781.Google Scholar
5. Stewart, RD, Paris, PM, Stoy, WA, et al: Patient-controlled inhalational analgesia in prehospital care: A study of side-effects and feasibility. Crit Care Med 1983;1:851–855.CrossRefGoogle Scholar
6. Kaplan, RM, Heller, MB, Paris, PM, et al: The effect of different combinations of external pacemakers and pads on pacing thresholds, capture rate, and patient tolerance. Ann Emerg Med 1988;17:750. Abstract.Google Scholar
7. Downie, WW, Leatham, PA, Rhind, VM, et al: Studies with pain rating scales. Ann Rheum Dis 1978;37:378–381.CrossRefGoogle ScholarPubMed
8. Zoll, PM, Zoll, RH, Falk, RH, et al: External noninvasive temporary cardiac pacing: Clinical trials. Circulation 1985;71:937–944.CrossRefGoogle ScholarPubMed
9. Falk, RH, Zoll, PM, Zoll, RH: Safety and efficacy of noninvasive cardiac pacing. N Engl J Med 1983;309:1166–1168.CrossRefGoogle ScholarPubMed
10. Heller, MB, Peterson, J, Ilkhanipour, K, et al: A comparative study of five transcutaneous pacing devices in unanesthetized human volunteers. Prehospital and Disaster Medicine 1989;4:15–20.CrossRefGoogle Scholar
11. Heller, MB, Kaplan, RM, Ilkhanipour, K, et al: Nitrous oxide analgesia during transcutaneous pacing in human volunteers. Ann Emerg Med 1988;17:750. Abstract.Google Scholar