Self-adjusted Nitrous Oxide During Urodynamic Studies Reduces Patient Pain Without Compromising Study Quality: A...

Area of Science:

• Urology
• Anesthesiology
• Patient Comfort

Background:

• Urodynamic studies (UDS) are essential for diagnosing lower urinary tract symptoms but can cause significant patient discomfort.
• Currently, effective analgesic options for UDS are limited, leading to patient reluctance.
• Self-adjusted nitrous oxide (SANO) offers a potential solution for pain and anxiety management during UDS.

Purpose of the Study:

• To evaluate the effectiveness of low-dose, self-adjusted nitrous oxide (SANO) during urodynamic studies (UDS).
• To assess the impact of SANO on standard bladder function metrics and patient-reported pain and anxiety.
• To compare SANO with oxygen in a randomized crossover trial for UDS procedures.

Main Methods:

• A double-blind, randomized crossover trial was conducted with adult patients undergoing UDS.
• Patients received either oxygen or SANO during two consecutive UDS runs, with treatment order randomized.
• UDS outcomes (capacity, detrusor strength, residual volume) and subjective patient reports (pain, anxiety) were compared.

Main Results:

• Urodynamic study outcomes did not significantly differ between SANO and oxygen.
• Patients reported significantly less pain and anxiety with SANO compared to oxygen (p=0.046).
• Verbal feedback during the procedure was significantly better with SANO (p=0.001), and 79% of patients preferred SANO for future UDS.

Conclusions:

• Low-dose, self-adjusted nitrous oxide (SANO) is a safe and effective method for reducing pain and anxiety during urodynamic studies.
• SANO preserves standard UDS metrics while significantly improving the patient experience.
• Nitrous oxide presents an attractive option for patients hesitant to undergo UDS due to discomfort.