An alternative for procedural pain
ENTONOX has been used widely in the treatment of pain resulting from medical interventions, investigations and treatments. As well as relieving pain, it has been found to reduce anxiety during minor surgical procedures, such as wound and burns dressings, wound debridement and suturing.
This ready-to-use gas mixture (consisting of 50% nitrous oxide and 50% oxygen) is an effective alternative to intravenous or intramuscular sedation during endoscopic procedures. In addition, the analgesic and anxiolytic properties of ENTONOX play an important role in overcoming the apprehension patients experience prior to painful procedures.
ENTONOX for short procedures
ENTONOX is used to provide safe and effective analgesia for percutaneous liver biopsies. A number of studies have also reported positive results from the use of ENTONOX during prostate biopsy (1, 2).
During colonoscopy, ENTONOX has been shown to be safe and effective compared to intravenous sedation techniques, with faster recovery times, reduced discomfort and nausea and shorter times for the patient to be discharged. Lindblom et al. found that patients who received nitrous oxide / oxygen mixtures usually left the colonoscopy unit earlier than those given intravenous sedation (3, 4, 5).
The analgesic and sedative properties of ENTONOX have also been investigated for fibreoptic bronchoscopy in adults and children. In adults, inhalation of an equimolar nitrous oxide/oxygen gas mixture has been shown to be effective in reducing patient pain and discomfort and a possible alternative to general anaesthesia (6). Among children, improved efficacy of sedation, pain control and safety has also been demonstrated (7).
(1) Masood J, Shah N, Lane T et al. Nitrous oxide (ENTONOX) inhalation and tolerance of transrectal ultrasound guided prostate biopsy; a double-blind controlled trial. J Urol 2002; 168(19):116-20.
(2) McIntyre IG, Dixon A, Pantelides ML. Entonox analgesia for prostatic biopsy. Prostate Cancer Prostatic Dis 2003; 6(3):235-8.
(3) Saunders B., Fukumoto M, Halligan S et al: Patient administered nitrous oxide/oxygen inhalation provides effective sedation and analgesia for coloscopy. Gastroint Endosc 1994; 40(4): 418-21.
(4) Lindblom A, Janson O, Jeppson B et al: Nitrous oxide for colonoscopy discomfort: A randomized double-blind study. Endoscopy 1994; 26: 283-86.
(5) Notini-Gudmarsson AK, Dolk A, Jakobsson et al: Nitrous oxide: A valuable alternative for pain relief and sedation during routine colonoscopy. Endoscopy 1996; 28(3):283-7.
(6) Atassi K, Mangiapan G, Fuhrman C et al. Prefixed equimolar nitrous oxide and oxygen mixture reduces discomfort during flexible bronchoscopy in adult patients. A randomized, controlled, double-blind trial. CHEST 2004; 125:315-321.
(7) Fauroux B. The efficiacy of premixed nitrous oxide and oxygen for fiberoptic bronchoscopy in pediatric patients: a randomized, double blind, controlled study. CHEST 2004; 125:315-321.