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Randomised controlled trial
The use of 50% nitrous oxide improves successful intravenous access in obese and growth-limited children in an outpatient setting
  1. David Rosen
  1. Department of Anesthesiology, Perioperative and Pain Medicine, Harvard Medical School, Children's Hospital Boston, Boston, Massachusetts, USA
  1. Correspondence to David Rosen
    Department of Anesthesiology, Perioperative and Pain Medicine, Harvard Medical School, Children's Hospital Boston, 300 Longwood Ave, MA 02115, USA; hdrosen{at}gmail.com

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Context

Intravenous therapy is a common intervention in paediatric medicine. Its uses include the delivery of fluids, nutrition, medication and venous blood sampling. Patient anxiety and difficulty with intravenous placement are common. Patients who require frequent peripheral intravenous placement can have progressive difficulty with intravenous access and can also experience increased anxiety related to the procedure. Obesity or growth retardation can make intravenous insertion more difficult.

Topical anaesthetic applied to the skin over an intravenous insertion site has been shown to decrease pain and anxiety related to the procedure.1 Oral midazolam and inhaled nitrous oxide are well studied common pharmacologic therapies noted to relieve anxiety and facilitate cooperation with procedures in children,2 3 but their role in improving successful intravenous access in children has not previously been evaluated.

Methods

A total of 90 children were studied prospectively. Of …

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