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Use of Nitrous Oxide for Minimal Sedation in Pediatric Outpatients: A Survey Analysis of Patient Experience and Parent-Guardian Satisfaction.

INTRODUCTION
The use of minimal and moderate sedation in the pediatric population allows for the successful completion of many procedures in both hospital and outpatient settings without the risks involved with general anesthesia. Sanford Children's outpatient sedation clinic had been using oral midazolam for minimal sedation but began using inhaled nitrous oxide in January 2019. The current study examines patient experience and parent/guardian satisfaction with use of inhaled nitrous oxide for minimal sedation.


DESIGN/METHODS
A survey was designed to evaluate parent/guardian satisfaction with nitrous oxide for pediatric sedation in various outpatient procedures. Parents'/ guardians' understanding of the sedation and procedural logistics were surveyed as well as their satisfaction with the child's comfort, recovery time, and overall satisfaction were assessed.


RESULTS
Thirty-seven surveys completed by parents/guardians of patients ages 1-16 years were collected. Average age of the patient was 6 years old, with 22 female and 15 male patients. Outpatient procedures for which the nitrous oxide sedation was used included 30 botulinum toxin injections, 5 VCUG, 1 vaccine administration, and 1 IV placement. Mean survey results were 9.6 (95 percent CI, 9.3-9.9) for satisfaction of recovery time, 8.5 (95 percent CI, 7.7-9.3) for control of discomfort, and 9.1 (95 percent CI, 8.5-9.7) for overall satisfaction.


CONCLUSIONS
When evaluating nitrous oxide as an agent for minimal sedation in pediatric procedures, parents/guardians were most satisfied with the recovery time and least satisfied with its ability to control discomfort. Overall, we concluded that nitrous oxide is a moderately good agent for pediatric patients receiving minimal sedation.