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Pediatric Rheumatology

, 6:1

First Online: 15 January 2008Received: 10 October 2007Accepted: 15 January 2008


BackgroundIntra-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.

ObjectiveTo 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.

MethodsNO 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.

Results54 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.

ConclusionNO provides effective and safe sedation for JIA children undergoing intra-articular injections.

Electronic supplementary materialThe online version of this article doi:10.1186-1546-0096-6-1 contains supplementary material, which is available to authorized users.

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Autor: Yosef Uziel - Gil Chapnick - Michal Rothschild - Tsivia Tauber - Joseph Press - Liora Harel - Philip J Hashkes


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