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. 2018 Feb 20:23:18.
doi: 10.4103/jrms.JRMS_473_17. eCollection 2018.

The effect of nitrous oxide in comparison to oxygen combined with fentanyl on the hospitalization time and pain reduction in renal colic patients at emergency department

Omid Ahmadi  1 , Amir Shirvani Dehkordi  1 , Farhad Heydari  1 , Mohammad Nasr Esfahani  1 , Behzad Mahaki  2
Affiliations

The effect of nitrous oxide in comparison to oxygen combined with fentanyl on the hospitalization time and pain reduction in renal colic patients at emergency department

Omid Ahmadi et al. J Res Med Sci. .

Abstract

Background: Renal colic is a painful medical emergency, needs urgent intervention to reduce pain. Nonsteroidal anti-inflammatory drugs, opioids, and entonox are pain-relieving agents. This study was aimed to compare fentanyl + entonox (nitrous oxide + O2) versus fentanyl + oxygen.

Materials and methods: One hundred and twenty patients with acute renal colic presenting to the emergency department were enrolled. First, 50 μg fentanyl was infused for all patients. Then, patients divided into two groups receiving masks of entonox and oxygen, respectively. Quantitative measurement of pain was performed by visual analog scale, before the intervention, after 3, 5, 10, and 30 min of that. If the pain was not relieved after 30 min, 50 μg fentanyl was infused. If the pain was still continued, ketorolac and ketamine were used. Hospitalization duration and severity of pain at specified times were compared between patients in two groups.

Results: The mean (standard deviation) time of hospitalization was 211 (59) and 236 (61) min in fentanyl + entonox and fentanyl + O2 groups, respectively (P = 0.024). The decrease in pain severity after 10 and 30 min in fentanyl + entonox group were significantly greater than fentanyl + O2 group (P = 0.002 and 0.001, respectively). Mean (standard error) of needed time for renal colic pain to get better was 11.27 (1.23) and 20.47 (1.71) min in fentanyl + entonox and fentanyl + O2 groups, respectively (P < 0.001). Proportion of patients relief from pain in fentanyl + entonox in the second, third, and fourth measurements were significantly more than fentanyl + O2 group (P = 0.036, P < 0.001, and P < 0.001, respectively).

Conclusion: Entonox is more effective to decrease the duration of hospitalization and reduction of pain than O2 in renal colic patients.

Keywords: Fentanyl; nitrous oxide; oxygen; renal colic.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Consort diagram of studied population
Figure 2
Figure 2
Comparison of renal colic recovery time in Group 1 and 2
Figure 3
Figure 3
Comparison of two groups regarding treatment response
See this image and copyright information in PMC

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References

    1. Shokeir AA, Abdulmaaboud M. Prospective comparison of nonenhanced helical computerized tomography and doppler ultrasonography for the diagnosis of renal colic. J Urol. 2001;165:1082–4. - PubMed
    1. Worcester EM, Coe FL. Clinical practice. Calcium kidney stones. N Engl J Med. 2010;363:954–63. - PMC - PubMed
    1. Esmailian M, Keshavarz M. Synergistic effects of citalopram and morphine in the renal colic pain relief; a randomized clinical trial. Emerg (Tehran) 2014;2:26–9. - PMC - PubMed
    1. Majidinejad S, Esmailian M, Emadi M. Comparison of intravenous ketamine with morphine in pain relief of long bones fractures: A Double blind randomized clinical trial. Emerg (Tehran) 2014;2:77–80. - PMC - PubMed
    1. Kariman H, Majidi A, Taheri S, Shahrami A, Hatamabadi HR. Analgesic effects of inhalation of nitric oxide (Entonox) and parenteral morphine sulfate in patients with renal colic; A randomized clinical trial. Bull Emerg Trauma. 2015;3:46–52. - PMC - PubMed