Comparison of analgesic and anxiolytic effects of nitrous oxide in burn wound treatment: A single-blind prospective randomized controlled trial

AIM: We compared the effects of 50% N(2)O and N(2)O titration in burn management to alleviate pain and anxiety associated with burn dressing. METHODS: In this single-blind prospective randomized controlled trial, 70 stable adult burn patients were randomized to 2 groups during May 2015 to January 2016. The experimental group was titrated with N(2)O ranging from 30% to the ideal sedation concentration before dressing change until the end. The control group was treated with 50% N(2)O 2 minutes before dressing change until the end. Pain, anxiety, vital signs, and the highest concentrations of N(2)O inhaled were recorded at 1 minute before N(2)O inhalation (T0), dismantling of outer (T1), inner dressings (T2), debridement (T3), drug-smearing (T4), bandaging (T5), and 10 minutes after completion of the procedure (T6). RESULTS: The pain and anxiety scores in the experimental group performed significantly less than the control group during T2-T6. The systolic blood pressure in T2 and the heart rate at T2 and T3 varied significantly between the 2 groups. The highest N(2)O concentrations of the experimental group were mainly 60% to 70% at T2 (87.9%), T3 (87.9%), and T4 (81.8%). CONCLUSION: N(2)O titration significantly reduced pain and anxiety in burn patients, with minimal side effects.