Section of Pediatric Rheumatology, Department of Rheumatic Diseases, Cleveland Clinic, USA.
Pediatr Rheumatol Online J. 2008 Jan 15;6:1. doi: 10.1186/1546-0096-6-1.
Intra-articular corticosteroid injection in juvenile idiopathic arthritis (JIA) is often associated with anxiety and pain. Recent reports advocate the use of nitrous oxide (NO), a volatile gas with analgesic, anxiolytic and sedative properties.
To prospectively evaluate the effectiveness and safety of NO analgesia for intra-articular corticosteroid injection in JIA, and to assess patients and staff satisfaction with the treatment.
NO was administered to JIA patients scheduled for joint injection. The patient, parent, physician and nurse completed visual-analog scores (VAS) (0-10) for pain, and a 5-point satisfaction scale. Change in heart rate (HR) during the procedure was recorded in order to examine physiologic response to pain and stress. Patient's behavior and adverse reactions were recorded.
54 procedures (72 joints) were performed, 41 females, 13 males; 39 Jewish, 13 Arab; mean age was 12.2 +/- 4.7 year. The median VAS pain score for patients, parents, physicians and nurses was 3. The HR increased >/= 15% in 10 patients. They had higher VAS scores as evaluated by the staff. The median satisfaction level of the parents and staff was 3.0 and 5.0 respectively. Adverse reactions were mild.
NO provides effective and safe sedation for JIA children undergoing intra-articular injections.
在幼年特发性关节炎（JIA）中，关节内皮质类固醇注射常伴有焦虑和疼痛。最近的报告提倡使用具有镇痛、抗焦虑和镇静作用的挥发性气体一氧化二氮（NO）。
前瞻性评估 NO 镇痛在 JIA 关节内皮质类固醇注射中的有效性和安全性，并评估患者和医护人员对治疗的满意度。
NO 被给予计划接受关节注射的 JIA 患者。患者、家长、医生和护士使用视觉模拟评分（VAS）（0-10）评估疼痛，并使用 5 分满意度量表进行评估。记录手术过程中心率（HR）的变化，以检查对疼痛和应激的生理反应。记录患者的行为和不良反应。
共进行了 54 次操作（72 个关节），其中 41 名为女性，13 名为男性；39 名为犹太人，13 名为阿拉伯人；平均年龄为 12.2 +/- 4.7 岁。患者、家长、医生和护士的 VAS 疼痛评分中位数为 3。10 名患者的 HR 增加了>/= 15%。他们的 VAS 评分由医护人员评估更高。家长和医护人员的满意度中位数分别为 3.0 和 5.0。不良反应轻微。
NO 为接受关节内注射的 JIA 儿童提供了有效和安全的镇静作用。
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