Clinical Trial Details
— Status: Completed
Administrative data
NCT number |
NCT04095494 |
Other study ID # |
UK |
Secondary ID |
|
Status |
Completed |
Phase |
|
First received |
|
Last updated |
|
Start date |
May 1, 2019 |
Est. completion date |
July 31, 2019 |
Study information
Verified date |
August 2019 |
Source |
Nantes University Hospital |
Contact |
n/a |
Is FDA regulated |
No |
Health authority |
|
Study type |
Observational [Patient Registry]
|
Clinical Trial Summary
In order to evaluate the perception of the Nantes health students we wish to place an
anonymous survey concerning their training, their knowledge of the legislative framework
governing the use of EMONO and their personal and professional experience around nitrous
oxide.
Description:
The use of nitrous oxide in the form of EMONO (Equimolar Mixture of Nitrous Oxide and Oxygen)
is common practice in the medical field in France since obtaining the AMM in France in 2001.
It is used daily in the hospital services for its analgesic and anxiolytic properties in
order to obtain a conscious sedation of the patient during the realization of painful care.
Its use in liberal practice has been authorized since 2009 in France following the
confirmation of its security by clinical studies.
In its medical use, the use of nitrous oxide is subject to numerous regulations; EMONO's
various presentations are on the I list of poisonous substances and are subject in part to
the regulation of narcotics (secure storage, obligation to report flights ...) in France. The
use of this substance can only be done under medical prescription, in adapted premises, by a
medical or paramedical staff specifically trained, and whose knowledge will be periodically
reevaluated. All conditions of use and storage of EMONO are specified in the French Code of
Public Health (Article L5123-2) and, since it is authorized in a non-hospital environment,
enhanced monitoring of pharmacovigilance and addictovigilance and a Risk Management Plan
(RMP) has been put in place.
Paradoxically, apart from the supervised medical use, it is very simple to obtain nitrous
oxide. It is found in particular in whipped cream cartridges in a pure concentration (100%
N2O) over-the-counter and unregulated. In this form it is transferred into balloons by
consumers in order to be inhaled. Also known as laughing gas, it is diverted from its
original use for its euphoric properties and its effects (visual and sensory distortions)
that last only a few minutes.
The regulations governing the use of nitrous oxide have been put in place because the
toxicity of the latter is recognized in particular during chronic use. The risks associated
with the acute consumption of nitrous oxide are essentially hypoxia with even cases of death
recorded in the literature. Nitrous oxide consumed chronically can inactivate vitamin B12 by
oxidizing its cobalt ion causing neurological pathologies (myoneuropathies).
The risks related to nitrous oxide are certainly rare but known. The fact that it can be
easily obtained gives this "legal drug" a special status combining rare but existing side
effects and the risk of public abuse.
The medical and paramedical professions are the more at risk populations as the use of this
molecule becomes more popular. In the literature, the death cases mainly concern dentists for
exemple.
The use of nitrous oxide in the form of EMONO is not necessarily part of the core curriculum
of medical and paramedical education but today requires specific training. However, all
health students will one day be brought to use it in the realization of painful care. It is
fundamental to respect the defined framework of this drug use so as not to end up in a
situation of abuse (on the part of patients as well as that of practitioners).
There is the question of student training. Is the initial medical training on nitrous oxide
sufficient? Do students have a fair perception of this medicine as well as its use and
misuse? In order to evaluate the perception of the students we wish to place an anonymous
questionnaire concerning their training, their knowledge of the legislative framework
governing the use of MEOPA and their personal and professional experience around nitrous
oxide.