A Pilot Trial of Disposable Nitrous Oxide Canisters in Providing Pain Control During Burn Dressing Changes

  • STATUS
    Recruiting
  • End date
    Dec 1, 2023
  • participants needed
    30
  • sponsor
    University of Manitoba
Updated on 29 May 2022
analgesia
narcotics
wound care
burn care
burn dressing
wound treatment

Summary

Improvements in burn care have resulted in increased survival. Despite these improved outcomes one of the leading challenges of burn care remains providing adequate analgesia during routine wound care and dressing changes. The traditional use of narcotics is challenging as the therapeutic window between analgesia and suppression of breathing becomes narrow with the intense pain and high doses of narcotics needed for dressing changes.

Description

The normal challenges of using narcotics are increased in burn patients, who have significantly altered metabolism. Unfortunately, the use of regular general anesthesia or conscious sedation is not a viable option due to the resources required, and as the hypermetabolism of burn injury would result in compromised wound healing with repeated periods of without eating related halting of nutritional intake. This has led to the use of a number of adjuncts ranging from nonmedical (virtual reality, mindfulness, hypnosis etc.) to medication (ketamine, anxiolytics etc.). Historically Nitrous oxide has been used in similar settings where severe procedural pain is of relatively shorter duration, such as tooth extraction, labor or minor surgical procedures. Nitrous oxide is a rapidly acting analgesic that takes effect seconds after inhalation, and lasts minutes. While a randomized trial of Nitrous oxide in burn care has been proposed, the only published information currently available is in a Chinese medical journal.

To address this a gap in knowledge, a pilot Randomized Controlled trial is proposed to evaluate if Nitrous Oxide in the form of limited dose inhaler canisters can be used to improve pain control during burn dressing changes compared to placebo canisters.

Details
Condition Burns, Pain, Acute
Treatment Placebo, Nitrous Oxide Inhalant Product
Clinical Study IdentifierNCT03695887
SponsorUniversity of Manitoba
Last Modified on29 May 2022

Eligibility

Yes No Not Sure

Inclusion Criteria

adult burn patients admitted to the Health Sciences Centre
total body surface area burned of 5-20%

Exclusion Criteria

admitted to intensive care unit
unable to participate in the measurement outcomes (sedated, cognitively impaired, unable to understand English or visually impaired)
medical condition that precludes using nitrous oxide (respiratory disease and significant cardiovascular disease 5)
pregnant
physically unable to hold the canister
<90% SaO2 on room air
face burn
pre-injury narcotics (relative exclusion)
use of IV ketamine
pre-existing lung injury
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