Evidence map›Paper›PMID 37898481›Full record

Trial reportRegional anesthesia and pain medicine2024

Nitrous oxide for the treatment of complex regional pain syndrome: a randomized blinded trial.

Jason Hale, Jijun Xu, Dong Wang, Fabio Rodriguez-Patarroyo, Omer Bakal, Orkun Kopac, Ece Yamak Altinpulluk, Ozkan Onal, Jack E Brooker, Miguel Cruz and 4 more

Open access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Regional anesthesia and pain medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.0field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 3 citations in OpenAlex.

  1. Trial
  2. Review
  3. Article
  4. Review
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 1 institution in 2 countries.

Jason HaleDepartment of Pain Management, Cleveland Clinic, Cleveland, Ohio, USA.
Jijun XuDepartment of Pain Management, Cleveland Clinic, Cleveland, Ohio, USA.ORCID 0000-0002-5137-8199
Dong WangDepartment of Outcomes Research, Cleveland Clinic, Cleveland, Ohio, USA.
Fabio Rodriguez-PatarroyoDepartment of Outcomes Research, Cleveland Clinic, Cleveland, Ohio, USA.
Omer BakalDepartment of Outcomes Research, Cleveland Clinic, Cleveland, Ohio, USA.
Orkun KopacDepartment of Outcomes Research, Cleveland Clinic, Cleveland, Ohio, USA.ORCID 0000-0002-2414-0951
Ece Yamak AltinpullukDepartment of Outcomes Research, Cleveland Clinic, Cleveland, Ohio, USA.ORCID 0000-0002-6993-0762
Ozkan OnalDepartment of Outcomes Research, Cleveland Clinic, Cleveland, Ohio, USA.
Jack E BrookerDepartment of Outcomes Research, Cleveland Clinic, Cleveland, Ohio, USA.
Miguel CruzDepartment of General Anesthesiology, Cleveland Clinic, Cleveland, Ohio, USA.
Marco MaurtuaDepartment of General Anesthesiology, Cleveland Clinic, Cleveland, Ohio, USA.
Ruben Agudelo-JimenezDepartment of Outcomes Research, Cleveland Clinic, Cleveland, Ohio, USA.
Daniel I SesslerDepartment of Outcomes Research, Cleveland Clinic, Cleveland, Ohio, USA.
Alparslan TuranDepartment of Outcomes Research, Cleveland Clinic, Cleveland, Ohio, USA turana@ccf.org.ORCID 0000-0001-9862-9306
Cleveland Clinic · US

Funding

Complement in Paclitaxel-induced peripheral neuropathyK08CA228039 · NCI · CLEVELAND CLINIC LERNER COM-CWRU · PI XU, JIJUN · 2020 to 2024
$1.2M
NCI NIH HHS K08 CA228039
6 · The paper itself

Abstract

introductionComplex Regional Pain Syndrome (CRPS) is a debilitating neuropathic condition often refractory to conventional treatments. N-methyl-D-aspartate (NMDA) receptor antagonists have a well-established role in the development and modulation of chronic neuropathic pain. Nitrous oxide is widely used and generally safe anesthetic gas with NMDA receptor antagonist activity. We therefore tested the hypothesis that brief periods of nitrous oxide exposure reduce pain in patients with CRPS.

methodsPatients with a diagnosis of CRPS were randomized to either 2 hours of nitrous oxide exposure on three alternating days (Nitrous Oxide) versus a placebo air/oxygen mixture (Air-Oxygen). Our primary outcome was patient-reported pain scores at 1 week and 1 month. Secondary and exploratory outcomes were physical and mental health (PRMOIS-29 v2 survey), specific neuropathic pain symptoms (McGill short-form questionnaire), and opioid consumption.

results44 patients participated in the study; 20 were randomized to Nitrous Oxide and 24 were assigned to Air-Oxygen. Pain scores did not differ significantly, with the estimated difference in means (Nitrous Oxide-Air-Oxygen) of -0.57 (95% CI: -1.42 to 0.28) points, p=0.19. There were also no differences detected in secondary outcomes, with the estimated difference in mean Z-scores for physical health (Nitrous Oxide-Air-Oxygen) of 0.13 (95% CI: -0.16 to 0.43), mental health 0.087 (95% CI: -0.31 to 0.48), and Patient Global Impression of Change score -0.7 (95% CI: -1.85 to 0.46).

conclusionsCompared with air/oxygen, 2 hours of nitrous oxide/oxygen exposure for three sessions did not provide meaningful therapeutic potential for patients with chronic CRPS. Our results do not support using nitrous oxide for the treatment of CRPS.

Indexed as

Anesthetics, InhalationComplex Regional Pain SyndromesNitrous OxideAdultAgedDouble-Blind MethodFemaleHumansMaleMiddle AgedPain MeasurementTreatment OutcomeAnesthetics, InhalationNitrous OxideComplex Regional Pain SyndromesPain ManagementPain Perception

Identifiers

PMID37898481
PMCPMC11055939
OpenAlexW4387999850

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.