Oxygen: Does it help with pain?????

[Comedic]

I am looking for information on if Oxygen help with pain.

I have found some information that supports that Oxygen helps with chest pain, back pain and migraines. But nothing else.


We put Oxygen on people and tell them this oxygen is going to help. I do it cause I know the brain thinks it's helping them.

I just need some information that support that if oxygen really helps with pain.


thanks

 

[mikeylikesit]

Depends on where the "pain" is stemming from. Say that someone has the Bends, or nerve oxygen deprivation...then yes O2 can really make the pain go away. i think you're speaking of a placebo effect or a conversion disorder where it helps them if the brain thinks it is helping.

 

[KEVD18]

depends on the pain.

chest pain- sure does. think about it. what is an mi? death of heart muscle due to..... now, if the obstruction is only partial, and you can increase the oxygenation of the blood, ultimately getting more oxygen to the anoxic cells; wouldnt that lessen the pain?

traumatic amputation- very doubtful. the theory is that hyper-oxygenation produces euphoria. while it may be accurate on one level, pumping me full of o2 isnt going to make my stump feel better. fent will.

some people can be tricked into thinking oxygen will make them feel better. then again, some people can be tricked into spending 29.95 on a .75in round copper engraving of abraham lincoln.

the only benefit to superfluous oxygenation is that, with the exception of some conditions like respiratory drive conversion, the only way you can hurt someone with o2 is if you hit them with the bottle.

 

[upstateemt]

some people can be tricked into thinking oxygen will make them feel better. then again, some people can be tricked into spending 29.95 on a .75in round copper engraving of abraham lincoln.

I don't think you are "tricking" people. The placebo effect is well documented, just as in the often used statement "pain is what the patient says it is when they say it is", releif comes in many forms. Oxygen will not hurt someone and if the patient experiences a decreased level of pain because the oxygen makes them feel like something is being done, or in some way comforts them, then you have performed a successful intervention. There is no "trickery" involved.

There are physiological reason that oxygen will help with pain but there are emotional responses that may decrease a patients level of pain as well.

 

[KEVD18]

there certainly is trickery. its merely trickery making use of the bodies natural processes(namely the placebo effect). its not trickery with harm intended, quite the opposite actually.

i see what your saying, but i stand by my post.

 

[upstateemt]

Well perhaps it is just semantics, but I don't think that is what you really mean....
Webster def of "trickery"

Main Entry: trick·ery
Pronunciation: \ˈtri-k(ə-)rē\
Function: noun
Date: 1796 : the practice of crafty underhanded ingenuity to deceive or cheat
synonyms see deception

 

[firecoins]

Well perhaps it is just semantics, but I don't think that is what you really mean....
Webster def of "trickery"

Main Entry: trick·ery
Pronunciation: \ˈtri-k(ə-)rē\
Function: noun
Date: 1796 : the practice of crafty underhanded ingenuity to deceive or cheat
synonyms see deception

its semantics. A placebo is a form of tricking people into believing that something is helpful and that it really becomes helpful.

 

[upstateemt]

AHHHHHHH, again I refer to Webster:

Main Entry: pla·ce·bo
Pronunciation: \plə-ˈsē-(ˌ)bō\
Function: noun
Inflected Form(s): plural pla·ce·bos
Etymology: Latin, I shall please
Date: 1785
1 a: a usually pharmacologically inert preparation prescribed more for the mental relief of the patient than for its actual effect on a disorder b: an inert or innocuous substance used especially in controlled experiments testing the efficacy of another substance (as a drug)
2: something tending to soothe

placebo seems much kinder and gentler than trickery

 

[firecoins]

placebo seems much kinder and gentler than trickery

what you have against "trickery"? Medicine tends to "manipulate" the body to get certain reactions. Does that bother you?

 

[upstateemt]

As both a nurse and an EMT I believe that being honest is important, "trickery" implies being less than honest. If my patient were to ask me if oxygen would help their (fill in the blank) pain. I would be honest in saying; I don't know but it won't hurt.

 

[mikie]

maybe it's just me, but I don't consider O2, when used with patients in pain, as a 'placebo.' Physiologically, it might not actually have an analgesic effect, but its more therapeutic. Helping one breathe, via O2 can in itself be therapeutic: controlling their breathing, giving them comfort of care...it all helps the patient cope with the pain rather than treat it.

Like people that prefer homeopathic medicine (maybe a bad example, I'm not too up-to-date on my homeopathics).

but that's just my small opinion...

 

[upstateemt]

You are correct Mike, I regret my use of the word "placebo". I was using it to describe a treatment that works but we don't really understand why, not to imply that the patient would be made to think it worked.

Pain causes anxiety, anxiety may cause a perceived sense of being short of breath. Oxygen can relieve that, resulting in a decreased sensation of pain. A real treatment for a real problem.

So my use of the word "placebo" is incorrect.

 

[VentMedic]

I've got a little reading assignment for ya'all.

http://cvphysiology.com/Blood Flow/BF008.htm

http://www.reuters.com/article/healthNews/idUSTON47321020080724?pageNumber=1&virtualBrandChannel=0

Our microsurgeons like their patients kept on O2 longer than other post-op patients. This may be for pain relief, healing properties and anxiety factors involved. Maybe it just keep the leeches more active longer.

upstate; as a BSN, CCRN, this should be very basic for you especially if you have done any ICU work. Remember the reasons we utilize SvO2 and SjvO2 monitoring? The SpO2 is deceiving.

 

[upstateemt]

Thanks, I was looking for some journal articles to reference but ran out of time (I supposed to be working). I did find alot of information on hyperbaric oxygen and pain control but no references to inhaled. The hyperbaric oxygen therapy for migraines and cluster headaches seems to be greatly disputed.

I do know that all our patients with pain receive high flow O2 unless they refuse. Annecdotely it works.

 

[mikeylikesit]

I think that O2 is best used to cure a conversion disorder...along with a hand full of Tic Tac's.

 

[mycrofft]

O2...not your old man's gas.

Placebo as in admistering a worthless treatment per se even if in the hope of postive effect is unethical and may be illegal, especially if you bill for treatment you don't give. (However, an O2 mask without O2 can be very swift in allaying hyperventilation; watch closely, don't leave it on very long!!!). Suggestion is different than placebo in that the placebo effect is internal to the pt in response to your positive suggestion, and no worthless treatment is administered..

Hyper-O2 can cause a climb in blood pH simulating hyperventialtion, especially if they ARE hyperventilating. If that goes on the breathlessness, and maybe even cramps and muscle contractions, will certainly NOT be helping alleviate pain.

O2 for decompression sickness is a palliative unless it is under hyperbaric pressure, but better than 21% room conc. Usually the O2 is via mask while the pt is placed in hyperbaric air, maybe a diver's mix.

Sometime, everyone ought to put on an O2 mask, and then (later, not concurrent) a nasal cannula, and see what it really is like, just like they oughta ride on the ambulance cot code three for a couple blocks.

PS: Good on y'all! No one came up with that old canard "If the pt has COPD,
O2 will kill her".

 

[MikeRi24]

I agree with whoever said it could potentially help the chest pain or other o2 deprivation oriented problem. I also agree that for, lets just say for conversation sake, a broken leg, that while it's unlikely to help the pain caused by the broken leg, I think that giving it to a pt and encouraging them to take some deep breaths and whatnot will not only help calm them down, but by making them focus more on taking deep breaths and breathing in the o2, it will probably help take thier mind off the pain.

 

[MMiz]

I absolutely believe that oxygen therapy helps with pain, though I can't tell if it's the actual oxygen or the whole "shebang" that makes the patient feel better. Someone mentioned the placebo effect, and I agree. Two stories.

When I was doing an EMS club at my school, I brought several bottles of O2 and several NRB. I had that, the LifePak 12, stretcher, etc. stored in the teacher's lounge. One of the teachers went in there, hooked up the O2 via NRB @ 25 LPM !?! and took a small break. By the end of the day there was a line out the door.

I remember once we were treating a patient for a jammed finger, and we had to transport to the hospital (per the guardian). When I went to take the patient out of the rig, my partner had literally bandaged, splinted, and padded every part of her body. She was on O2 via NC at 2 LPM. I couldn't help but wonder what was going on. When we dropped her off in the ER, the doctor asked what the heck was going on here, and my partner responded "Doc, if I would have offered to start bagging her with the BVM while shocking her with the AED, she would have said yes." He just smiled and started taking the bandages off.

It's amazing what comforts patients, and I think O2 is one of those comforts.

 

[VentMedic]

Placebo as in admistering a worthless treatment per se even if in the hope of postive effect is unethical and may be illegal, especially if you bill for treatment you don't give. (However, an O2 mask without O2 can be very swift in allaying hyperventilation; watch closely, don't leave it on very long!!!). Suggestion is different than placebo in that the placebo effect is internal to the pt in response to your positive suggestion, and no worthless treatment is administered..

Hyper-O2 can cause a climb in blood pH simulating hyperventialtion, especially if they ARE hyperventilating. If that goes on the breathlessness, and maybe even cramps and muscle contractions, will certainly NOT be helping alleviate pain.

O2 for decompression sickness is a palliative unless it is under hyperbaric pressure, but better than 21% room conc. Usually the O2 is via mask while the pt is placed in hyperbaric air, maybe a diver's mix.

Sometime, everyone ought to put on an O2 mask, and then (later, not concurrent) a nasal cannula, and see what it really is like, just like they oughta ride on the ambulance cot code three for a couple blocks.

PS: Good on y'all! No one came up with that old canard "If the pt has COPD,
O2 will kill her".

Hyperoxia is not hyperventilation. The Hb will reach their saturation point and the partial pressure of the PaO2 will remain. We will put patients on high concentrations of O2 for various protocols including sepsis until the serum lactate starts to decrease.

Putting a mask without O2 on anyone is like putting someone in a plastic bag. You, in the prehospital situation, do not know the cause of the "hyperventilation" which can trully only be determined by an ABG. You will have no idea what the acid-base situation is or if there is significant V/Q mismatching. In the ED I've intubated more than one of these "victims" of some EMS provider assuming "hyperventilation". People who can not breathe tend to get a little anxious.

Giving the patient a little O2 may do more to alleviate their "hyperventilation".

As for as DCS, oxygen is not just pallative. You can find this information on either the DAN website or The Undersea & Medical Society.

http://www.diversalertnetwork.org/

http://www.uhms.org/Default.aspx?tabid=270

The use of first aid oxygen has proven so beneficial that the Divers Alert Network (DAN) has made a major effort to place oxygen at dive locations, in particular those that are remote with lengthy transport times to the nearest hyperbaric chambers and to ensure that people are trained in its use. A study of the use of first aid oxygen found that the median time to its use after surfacing was 4 hours and 2.2 hours after the onset of DCS symptoms. Forty-seven percent of victims received the oxygen. Complete relief of symptoms was found in 14% of victims. Even more striking was that 51% of victims showed improvement. This was with the oxygen before HBO treatment. Even after a single HBO treatment, those that had received oxygen before the HBO dive, even if many hours earlier, had better outcomes.

 

[Comedic]

I want to thank everyone for answering my thread............ good stuff

I have to agree on placebo effect. I have put countless patients on oxygen telling the that it will help. Then of course when it didn't help I would load them on some Fent.

It just seems to me we would put oxygen on patients to clam them down and if you plan not giving the patient any pain control.

Wouldnt that help wear off the endorphins or even wear off the Epi dump in the system.

Don't get me wrong I'll still put oxygen on when needed. If someone refuse oxygen I will still tell them that it will help.

So oxygen has to help in some way excluding the placebo effect and in any respiratory distress. Let think about how it works on a trauma patient. Does it help the healing process by situation of oxygen to tissues. If not then why do we monitor PsO2 and keep it above 90%.