# Understanding Nurses' and Physicians' Knowledge, Use and Perspectives on Nitrous Oxide/Oxygen Use in Paediatrics: A Cross‐Sectional Study

## TL;DR

This study explores how nurses and doctors in Italy use and view nitrous oxide/oxygen for sedating children during medical procedures.

## Contribution

The study identifies barriers like lack of training and equipment that prevent wider use of a safe sedation method in pediatric care.

## Key findings

- Only 40.7% of healthcare professionals currently use nitrous oxide/oxygen in their clinical units.
- Lack of equipment and training are the main barriers to adoption.
- Emergency unit employment and three-year nursing degrees predict N2O/O2 use.

## Abstract

Nitrous oxide/oxygen (N2O/O2 50%/50%) is an effective and safe technique for procedural sedation in paediatric settings; however, the knowledge, use and perspectives of healthcare professionals regarding N2O/O2 remain limited.

To investigate the knowledge, use and perspectives of healthcare professionals regarding N2O/O2 in maternal–infant and emergency units.

A cross‐sectional study was conducted (March to December 2024) using (i) a sociodemographic information tool and (ii) a 16‐item questionnaire assessing knowledge, clinical use, perceived barriers and willingness to adopt N2O/O2. Descriptive and multivariate analyses were performed.

Of 113 respondents, 40.7% reported currently using N2O/O2 in their clinical units, while 91.0% of non‐users expressed willingness to adopt it. Barriers included lack of equipment (92.9%) and training (84.1%). 91.1% considered N2O/O2 ethically acceptable, consistent with principles of beneficence, non‐maleficence and child comfort. Employment in emergency units and holding a three‐year nursing degree were significant predictors of N2O/O2 use.

Limited Use of N2O/O2 in Italian Paediatrics Contrasts With Strong Professional Interest. Improving Training and Resources Could Enhance Access to Safe Paediatric Sedation.

Training, equipment and guidelines are needed to translate willingness into real clinical practice, improving the safety and consistency of paediatric sedation.

What is known about the topic
○Nitrous oxide/oxygen is a safe and effective method for sedation in paediatrics.○There is limited knowledge about healthcare professionals' experiences, perspectives and attitudes regarding the use of N2O/O2 in paediatric procedural sedation.
What this paper adds
○Nurses and physicians are willing to use it, but its use remains limited.○Barriers to nitrous oxide/oxygen use include a lack of protocols, equipment and training.○Setting and educational level seem to predict nitrous oxide/oxygen use in practice.

What is known about the topic
○Nitrous oxide/oxygen is a safe and effective method for sedation in paediatrics.○There is limited knowledge about healthcare professionals' experiences, perspectives and attitudes regarding the use of N2O/O2 in paediatric procedural sedation.

Nitrous oxide/oxygen is a safe and effective method for sedation in paediatrics.

There is limited knowledge about healthcare professionals' experiences, perspectives and attitudes regarding the use of N2O/O2 in paediatric procedural sedation.

What this paper adds
○Nurses and physicians are willing to use it, but its use remains limited.○Barriers to nitrous oxide/oxygen use include a lack of protocols, equipment and training.○Setting and educational level seem to predict nitrous oxide/oxygen use in practice.

Nurses and physicians are willing to use it, but its use remains limited.

Barriers to nitrous oxide/oxygen use include a lack of protocols, equipment and training.

Setting and educational level seem to predict nitrous oxide/oxygen use in practice.