Objective: To investigate the application effects of
nitrous oxide and
oxygen mixed inhalation technology on
analgesia and sedation during
debridement and dressing change in children with moderate or severe
burns. Methods: A retrospective non-randomized contemporary controlled study was conducted. From December 2019 to November 2021, 140
burn children with moderate or severe
burns, aged 1 to 3 years, who met the inclusion criteria were admitted to Central Hospital Affiliated to Shandong First Medical University. During
debridement and dressing change 3 to 14 days after injury, 42 children, including 23 males and 19 females, who received nurse-centered
pain management mode and
analgesia and sedation with
nitrous oxide and
oxygen mixed inhalation technology were included in
nitrous oxide group (the dressing change process using the above-mentioned technology for the first time was selected for the follow-up study). Another 42 children, including 24 males and 18 females, were included in non-
nitrous oxide group from 98 children who did not apply
analgesia or sedation treatment during dressing change with stratified random sampling (one dressing change process was randomly selected for the follow-up study). The face, legs, activity, cry, and consolability scale and Ramsay sedation scale were used to evaluate the
pain intensity and degree of sedation, respectively, at 30 minutes before dressing change (hereinafter referred to as before dressing change), immediately after
debridement, and at 30 minutes after finishing dressing change (hereinafter referred to as after dressing change). After dressing change, the self-made satisfaction scale was used to evaluate the satisfaction degree of dressing change surgeons and guardians of children for
analgesic effects during dressing change. The duration of dressing change and the healing time of deep partial-thickness
burn wounds were recorded. The heart rate and percutaneous arterial oxygen saturation (SpO2) before, during, and after dressing change and the occurrence of adverse events such as
nausea and
vomiting during dressing change were recorded. Data were statistically analyzed with Mann-Whitney U test, chi-square test, analysis of variance for repeated measurement, independent sample t test, and Bonferroni correction. Results: There were no significant differences in the score of
pain intensity and score of sedation degree between children in two groups before and after dressing change (P>0.05). Immediately after
debridement, the score of
pain intensity of children in
nitrous oxide group was 2.5±0.7, which was significantly lower than 7.6±1.0 in non-
nitrous oxide group (t=-26.69, P<0.05); the score of sedation degree of children in
nitrous oxide group was 1.83±0.38, which was significantly higher than 1.21±0.42 in non-
nitrous oxide group (t=7.15, P<0.05). After dressing change, the satisfaction degree scores of dressing change surgeons and guardians of children for
analgesic effects during dressing change of children in
nitrous oxide group were significantly higher than those in non-
nitrous oxide group (with t values of 10.53 and 2.24, respectively, P<0.05). The dressing change duration of children in
nitrous oxide group was significantly shorter than that in non-
nitrous oxide group (t=-5.33, P<0.05). The healing time of deep partial-thickness
burn wounds in children between the two groups had no significant difference (P>0.05). The heart rate of children in
nitrous oxide group was significantly lower than that in non-
nitrous oxide group during dressing change (t=-12.40, P<0.05), while the SpO2 was significantly higher than that in non-
nitrous oxide group (t=5.98, P<0.05). During dressing change, 2 children had
nausea and 1 child had euphoria in
nitrous oxide group, while heart rate of all children in non-
nitrous oxide group continued to be higher than the normal range. Conclusions: In the process of
debridement and dressing change in children with moderate or severe
burns, the use of nurse-centered
pain management mode and the standardized use of
nitrous oxide and
oxygen mixed inhalation technology can safely and effectively control
pain and sedation.