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Papers of the Week

2022 Sep 14

Ned Tijdschr Geneeskd


[Nitrous oxide is not widely used for children in the emergency departments in The Netherlands].


Hulshof GWL, Welsing RTC, Kluijfhout WP
Ned Tijdschr Geneeskd. 2022 Sep 14; 166.
PMID: 36300454.


Nitrous oxide was introduced in The Netherlands as an easily accessible and effective agent for procedural sedation and analgesia (PSA) in children at the Emergency Department. It was expected that its adoption would increase due to the rapid onset of action, limited side effects and the non-invasive character. In this article, we discuss the efficacy and use of nitrous oxide in The Netherlands. Nitrous oxide is a safe and effective agent for children undergoing low-complex procedures. However, the analgesic effect is limited for complex procedures such as fracture reposition, necessitating the use of additional agents such as opioids. Against our expectations, most Dutch Emergency Departments do not use nitrous oxide. Reasons for this are the limited analgesic effects for most procedures, the availability of good alternatives and cost and sustainability considerations.