• Manuel Murciano, Claudia Laterza, Ettore Attolini, Sonia Storelli, Giovanni Dipietro, Antonio Rubino, and Giuseppina Annicchiarico.
• Regional Coordination of Rare Diseases (CoReMaR), Apulia Regional Agency for Health and Social Care (AReSS), Bari, Italy.
• Medicine (Baltimore). 2022 Jan 7; 101 (1): e28474.

RationaleEpidermolysis bullosa (EB) is an inherited disease characterized by fragile skin with painful blistering, which requires lifelong skin and wound care. This case report describes the use of inhaled nitrous oxide (N2O) for procedural pain control at home during wound care in a young man with severe dystrophic EB. To our knowledge, only 1 case was reported by Ingelmo et al in 2017 regarding the use of N2O at home in a 4-year-old-child. To date, no such attempt has been made in adult patients.Patient ConcernsOur patient was a 28-year-old man. Frequent blisters appear spontaneously, and are often preceded by erythema and itching. Patient required daily treatment daily consisting of lancing blisters with a needle and emptying them by compression.DiagnosesSevere recessive dystrophic EB diagnosed at the time of delivery.InterventionsProcedural pain control was managed by the auto-administration of an inhaled N2O and air gas mixture.OutcomesConscious sedation with N2O leads to beneficial effects, such as reduction in dressing duration, acute procedural pain, local antibiotic needing, medication memory, anxiety, anticipatory pain, and fatigue after the dressing session.LessonsN2O analgesia is safe and effective, resulting in a significant reduction in procedural pain and an improvement in the quality of life of patients and their caregivers.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

40 keywords...

hide…