Managing pain and anxiety during transabdominal chorionic villus sampling. A noninferiority randomized trial of nitrous oxide vs local anesthesia.

Introduction: Transabdominal chorionic villus sampling (CVS) is an invasive procedure for prenatal diagnosis reported to be associated with anxiety and pain. In this context, the need for analgesia during CVS has been considered useful. Even though several authors have been interested in pain manage...

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Publicado en:Acta Obstetricia et Gynecologica Scandinavica Vol. 98; no. 3; pp. 351 - 359
Autores principales: Katsogiannou, Maria, Donato, Xavier‐Côme, Loundou, Anderson, Glowaczower, Eric, Raffray, Marie, Planchet‐Barraud, Brigitte, Quarello, Edwin, Brechard, Marie‐Pierre, Desbriere, Raoul, Donato, Xavier-Côme, Planchet-Barraud, Brigitte, Brechard, Marie-Pierre
Formato: research randomized controlled trial Journal Article
Publicado: Wiley-Blackwell Mar2019
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Managing pain and anxiety during transabdominal chorionic villus sampling. A noninferiority randomized trial of nitrous oxide vs local anesthesia.
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        au:
          Katsogiannou, Maria
          Donato, Xavier‐Côme
          Loundou, Anderson
          Glowaczower, Eric
          Raffray, Marie
          Planchet‐Barraud, Brigitte
          Quarello, Edwin
          Brechard, Marie‐Pierre
          Desbriere, Raoul
          Donato, Xavier-Côme
          Planchet-Barraud, Brigitte
          Brechard, Marie-Pierre
        affil: Department of Obstetrics and Gynecology, Hôpital Saint Joseph, Marseille France
      sug:
        subj:
          Nitrous Oxide Administration and Dosage
          Pain Prevention and Control
          Pain Therapy
          Chorionic Villi Sampling Adverse Effects
          Anesthesia, Local Methods
          Female
          Pain Measurement
          Adult
          Human
          Pregnancy
          Pain Etiology
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Randomized Controlled Trials
          Adult: 19-44 years
          Female
      ab: Introduction: Transabdominal chorionic villus sampling (CVS) is an invasive procedure for prenatal diagnosis reported to be associated with anxiety and pain. In this context, the need for analgesia during CVS has been considered useful. Even though several authors have been interested in pain management during amniocentesis, no study has been published on pain reduction during CVS. Our objective was to evaluate pain and anxiety management during transabdominal CVS using nitrous oxide (N2 O) and local anesthesia.Material and Methods: In a randomized controlled noninferiority trial, self-administered nitrous oxide (N2 O) inhalation (equimolar premix of oxygen and nitrous oxide) was compared with local anesthesia (1% lidocaine) before CVS. Primary outcome was pain and secondary outcome was anxiety, both measured on a visual analog scale 30-60 minutes before, immediately after (5-10 minutes) and 30-60 minutes after CVS. With a statistical power of 90%, type I error of 5% and two-sided test and potential exclusions, a sample size of 96 patients per group was enrolled and randomized. No patient was enrolled before the trial registration date.Results: From 13 March 2013 through 10 February 2015, 192 patients (96 per group) were screened and randomized. Most characteristics were similar across groups. Pain in the N2 O group was 2.65 ± 0.22 vs 3.32 ± 0.26 in local anesthesia group [mean ± standard error of mean  (SEM)]. Mean anxiety in the N2 O group was 3.17 ± 0.27 vs 5.19 ± 0.30 in the local anesthesia group.Conclusion: N2 O was as efficient and even superior to local anesthesia for both pain and anxiety reduction during CVS, as the 95% confidence intervals were both below the prespecified noninferiority margin of 0.8 and below zero.
      pubtype: Academic Journal
      doctype:
        research
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
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