BACKGROUND: Various strategies to mitigate children's distress during voiding cystourethrography (VCUG) have been described. Sedation with nitrous oxide is comparable to that with oral midazolam for VCUG, but a side-by-side comparison of nitrous oxide sedation and routine care is lacking. OBJECTIVE: The effects of sedation/analgesia using 70% nitrous oxide and routine care for VCUG and radionuclide cystography (RNC) were compared. MATERIALS AND METHODS: A sample of 204 children 4-18 years of age scheduled for VCUG or RNC with sedation or routine care were enrolled in this prospective study. Nitrous oxide/oxygen (70%/30%) was administered during urethral catheterization to children in the sedated group. The outcomes recorded included observed distress using the Brief Behavioral Distress Score, self-reported pain, and time in department. RESULTS: The study included 204 patients (99 nonsedated, 105 sedated) with a median age of 6.3 years (range 4.0-15.2 years). Distress and pain scores were greater in nonsedated than in sedated patients (P < 0.001). Time in department was longer in the sedated group (90 min vs. 30 min); however, time from entry to catheterization in a non-imaging area accounted for most of the difference. There was no difference in radiologic imaging time. CONCLUSION: Sedation with nitrous oxide is effective in reducing distress and pain during catheterization for VCUG or RNC in children.
BACKGROUND: Various strategies to mitigate children's distress during voiding cystourethrography (VCUG) have been described. Sedation with nitrous oxide is comparable to that with oral midazolam for VCUG, but a side-by-side comparison of nitrous oxide sedation and routine care is lacking. OBJECTIVE: The effects of sedation/analgesia using 70% nitrous oxide and routine care for VCUG and radionuclide cystography (RNC) were compared. MATERIALS AND METHODS: A sample of 204 children 4-18 years of age scheduled for VCUG or RNC with sedation or routine care were enrolled in this prospective study. Nitrous oxide/oxygen (70%/30%) was administered during urethral catheterization to children in the sedated group. The outcomes recorded included observed distress using the Brief Behavioral Distress Score, self-reported pain, and time in department. RESULTS: The study included 204 patients (99 nonsedated, 105 sedated) with a median age of 6.3 years (range 4.0-15.2 years). Distress and pain scores were greater in nonsedated than in sedated patients (P < 0.001). Time in department was longer in the sedated group (90 min vs. 30 min); however, time from entry to catheterization in a non-imaging area accounted for most of the difference. There was no difference in radiologic imaging time. CONCLUSION: Sedation with nitrous oxide is effective in reducing distress and pain during catheterization for VCUG or RNC in children.
Authors: Nader Shaikh; Alejandro Hoberman; Ron Keren; Anastasia Ivanova; Harvey A Ziessman; Gang Cui; Tej K Mattoo; Sonika Bhatnagar; Milan D Nadkarni; Marva Moxey-Mims; William A Primack Journal: Pediatr Radiol Date: 2016-06-10
Authors: Louis Kim; Minh Tung Do; Hyuk Dal Jung; Young Jae Im; Kyu Chang Wang; Ji Yeon Lee; Kwanjin Park Journal: Int Neurourol J Date: 2022-02-19 Impact factor: 2.835