Safety and efficacy of an equimolar mixture of oxygen and nitrous oxide: a randomized controlled trial in patients with peripheral neuropathic pain.


Journal

Pain
ISSN: 1872-6623
Titre abrégé: Pain
Pays: United States
ID NLM: 7508686

Informations de publication

Date de publication:
01 04 2021
Historique:
received: 13 05 2020
accepted: 05 10 2020
pubmed: 13 10 2020
medline: 20 5 2021
entrez: 12 10 2020
Statut: ppublish

Résumé

Nitrous oxide (N2O) is an odorless and colorless gas routinely used as an adjuvant of anesthesia and for short-duration analgesia in various clinical settings mostly in the form of an N2O/O2 50%-50% equimolar mixture (EMONO). Experimental studies have suggested that EMONO could also induce long-lasting analgesic effects related to the blockade of N-methyl-D-aspartate receptors. We designed the first international multicenter proof of concept randomized, placebo-controlled study to assess the efficacy and safety of a 1-hour administration of EMONO or placebo (medical air) on 3 consecutive days up to 1 month after the last administration in patients with chronic peripheral neuropathic pain. A total of 240 patients were recruited in 22 centers in France and Germany and randomly assigned to 1 study group (120 per group). Average pain intensity (primary outcome), neuropathic pain characteristics (Neuropathic Pain Symptom Inventory), Patient Global Impression of Change, anxiety, depression, and quality of life were systematically assessed before and after treatment. The changes in average pain intensity between baseline and 7 days after the last administration were not significantly different between the 2 groups. However, evoked pain intensity (predefined secondary endpoint) and Patient Global Impression of Change (exploratory endpoint) were significantly improved in the EMONO group, and these effects were maintained up to 4 weeks after the last treatment administration. Mostly transient side effects were reported during the treatment administration. These encouraging results provide a basis for further investigation of the long-term analgesic effects of EMONO in patients with neuropathic pain.

Identifiants

pubmed: 33044394
pii: 00006396-202104000-00012
doi: 10.1097/j.pain.0000000000002109
doi:

Substances chimiques

Nitrous Oxide K50XQU1029
Oxygen S88TT14065

Banques de données

ClinicalTrials.gov
['NCT02957851']

Types de publication

Journal Article Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1104-1115

Informations de copyright

Copyright © 2020 International Association for the Study of Pain.

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Auteurs

Didier Bouhassira (D)

Inserm U987, APHP, CHU Ambroise Paré, UVSQ, Paris-Saclay, Boulogne-Billancourt, France.

Serge Perrot (S)

CETD, CHU Cochin, APHP, Paris-Descartes University, Inserm U987, Paris, France.

Thibault Riant (T)

CETD M Bensignor, Hôpital privé du confluent, Groupe Vivalto Santé, Nantes, France.

Gaelle Martiné-Fabre (G)

Chronic Pain Center, CHU Limoges, Limoges, France.
Algology Consultation, Clinique Chenieux, Limoges, France.

Gisèle Pickering (G)

Clinical Research Center/CIC Inserm 1405, University Hospital, Clermont-Ferrand, France.
Fundamental and Clinical Pharmacology of Pain Neuro-Dol Inserm U1107, University Clermont Auvergne, Medical Faculty, Clermont-Ferrand, France.

Caroline Maindet (C)

Pain Management Center, Anesthesia and Intensive Care Unit, CHU Grenoble-Alpes, Grenoble, France.

Nadine Attal (N)

Inserm U987, APHP, CHU Ambroise Paré, UVSQ, Paris-Saclay, Boulogne-Billancourt, France.

Stéphanie Ranque Garnier (S)

Aix-Marseille University, CNRS, Ecole Centrale Marseille, UMR 7249, Institut Fresnel, Marseille, France.
CETD, CHU la Timone, APHM, Marseille, France.

Jean-Paul Nguyen (JP)

Multidisciplinary Pain Center, Clinique Bretéché, Groupe ELSAN, Nantes, France.

Emmanuelle Kuhn (E)

Multidisciplinary Pain, Palliative and Supportive care, Integrative Medicine Center, Hôpital Georges et René-Laennec, CHU Nantes, Nantes, France.

Eric Viel (E)

CETD, CHU Nîmes, Montpellier-Nîmes Faculty of Medicine, Nîmes, France.

Patrick Kieffert (P)

Pain Department, Hôpital Mercy, CHR Metz-Thionville, Metz, France.

Thomas Tölle (T)

Department of Neurology, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.

Claire Delorme (C)

CH Aunay-Bayeux, CETD, Bayeux, France.

Rodrigue Deleens (R)

CETD, CHU Rouen, Rouen, France.

Patrick Giniès (P)

CETD, Hôpital Saint-Eloi, CHRU Montpellier, Montpellier, France.
Clinical Investigation Center, Hôpital Saint-Eloi, Montpellier, France.

Virginie Corand-Dousset (V)

CETD, Hôpital Pellegrin, CHU Bordeaux, Bordeaux, France.

Clémence Dal-Col (C)

CETD, CHRU Jean Minjoz, Besançon, France.

Alain Serrie (A)

AP HP, Hôpital Lariboisière-Fernand-Widal, Paris Descartes-Paris Diderot Universities, Pain and Palliative Care Department, Inserm UMR-S 1144, Paris, France.

Emmanuel Chevrillon (E)

Clinique du Bourget, RAMSAY Santé, Le Bourget, France.

Christian Gov (C)

CETD, Hôpital Neurologique Pierre Wertheimer, HCL, Bron, France.

Juan Fernando Ramirez-Gil (JF)

Air Liquide Santé International, Les Loges en Josas, France.

Cécile Delval (C)

Air Liquide Santé International, Les Loges en Josas, France.

Manuella Schaller (M)

Air Liquide Santé International, Les Loges en Josas, France.

Baptiste Bessière (B)

Air Liquide Santé International, Les Loges en Josas, France.

Patrick Houéto (P)

Air Liquide Santé International, Les Loges en Josas, France.

Claudia Sommer (C)

Department of Neurology, University of Würzburg, Würzburg, Germany.

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