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  • Title: Nitrous oxide/oxygen mixture for analgesia in adult cancer patients with breakthrough pain: A randomized, double-blind controlled trial.
    Author: Liu Q, Gao LL, Dai YL, Li YX, Wang Y, Bai CF, Mu GX, Chai XM, Han WJ, Zhou LJ, Zhang YJ, Tang L, Liu J, Yu JQ.
    Journal: Eur J Pain; 2018 Mar; 22(3):492-500. PubMed ID: 29226545.
    Abstract:
    BACKGROUND: The aim of this study was to assess the efficacy of a fixed nitrous oxide/oxygen mixture for the management of breakthrough cancer pain. METHODS/DESIGN: A double-blind, placebo-controlled, randomized clinical trial was undertaken in the Medical ward of Tumor Hospital of General Hospital of Ningxia Medical University. 240 cancer patients with breakthrough pain were recruited and randomly received a standard pain treatment (morphine sulphate immediate release) plus a pre-prepared nitrous oxide/oxygen mixture, or the standard pain treatment plus oxygen. The primary endpoint measure was the numerical rating scale (NRS) score measured at baseline, 5 and 15 min after the beginning of treatment, and at 5 min post treatment. RESULT: In all, analysis of pain score (NRS) at 5 min after the beginning of treatment shown a significant decrease in nitrous oxide/oxygen mixture treated patients with 2.8 ± 1.3 versus 5.5 ± 1.2 in controls (p < 0.01). At 15 min during the intervention, the mean pain score for nitrous oxide/oxygen was 2.0 ± 1.1 compared with 5.6 ± 1.3 for oxygen (p < 0.01). CONCLUSION: This study shows that self-administered nitrous oxide/oxygen mixture was effective in reducing moderate to severe breakthrough pain among patients with cancer. SIGNIFICANCE: The management of breakthrough cancer pain is always a challenge due to its temporal characteristics of rapid onset, moderate to severe in intensity, short duration (median 30-60 min). Our study find that self-administered nitrous oxide/oxygen mixture was effective in reducing moderate to severe breakthrough cancer pain.
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