Indian Journal of Clinical Anaesthesia


A study on the feasibility of using ENTONOX as an analgesic in the casualty for pain relief vs fentanyl


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Author Details: R. Brindha, B. Arun Kumar, M. Aathura Das, M. Senthil, R. Shankar

Volume : 4

Issue : 2

Online ISSN : 2394-4994

Print ISSN : 2394-4781

Article First Page : 251

Article End Page : 256


Abstract

Background: Nitrous oxide (N2O) is a gas, which provides good analgesia without many side effects for short procedures outside the operating room.It is combined with 50% oxygen and is available in premixed cylinders as Entonox . In our quest to find a safer alternative we decided to compare fentanyl with Entonox for acute pain and for small painful procedures in the casualty.
Aim: To assess the effectiveness, feasibility and acceptance of Entonox in providing pain relief for patients who present with acute pain and for providing pain relief in short procedures in the casuality in comparison with fentanyl.
Materials and Methods: A prospective single blinded randomized comparative study was conducted in Vinayaka Missions superspeciality hospital a unit of VinayakaMissions KirupanandaVariyar Medical College, Salem during the period between March 2014 and Feb 2015. The patients with pre- treatment score more than six (Pre VAS > 6) or planned for painful procedures were taken up for the study. . Group A was considered as the control group where all the patients received injection Fentanyl 2 micrograms per kg and group B was considered as the study group where all the patients received entonox.Fifty patients were done under each group.
Results: The pain score of the patients were measured after giving the drugs at the interval of 10mins, 20mins and 30mins. The mean score of the patients in the entonox group at the end of 10mins was 3.16 and in fentanyl group it was 3.91 and similarly at the end of 20mins it was 2.98 in the entonox group and 3.42 in fentanyl group and there was a statistically significant difference between the two groups. The mean pain score at the end of 30mins was 1.48 and 1.78 in entonox and fentanyl group respectively and there was no statistical significant difference between the two groups. The adverse events like drowsiness and hypotension was more common in fentanyl group than that of entonox group and the difference was statistically significant (p<.05). In fentanyl group four patients developed respiratory failure and required assisted ventilation for 30mins,whereas no such incident had occurred in entonox group.
Conclusion: Entonox is a safe and effective analgesic for minor procedures and in alleviating acute pain. It is cost effective and poses no significant risk to the patients in the form of hemodynamic changes or respiratory depression.

Keywords:
Fentanyl, Entonox, Acute pain management