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cheap oakley sunglasses The efficacy of N2O as a sole agent in very painful procedures is limited.The use of nitrous oxide (N2O) for paediatric procedural sedation has been reported from many countries.1 6 Most research has used 50% N2O and there have been concerns regarding the variability of the analgesia and sedation provided.1 7 It has been suggested that N2O should not be used for procedures causing more than a low level of pain.8 Randomised controlled trials of the use of N2O for painful procedures in the paediatric emergency department (ED) have been reported since 1998,2 and in recent years the use of 70% N2O has become accepted and more widespread, with its use expanded to other settings.9 10 However, the efficacy of N2O for painful procedures has yet to be completely defined.The primary objective of our study was to characterise the efficacy of N2O for procedural sedation and analgesia (PSA) in a paediatric ED.MATERIALS AND METHODSDesign and settingWe conducted a prospective observational study in the ED of a large, urban children’s hospital with an annual ED census of60 000 patients. All children presenting to the ED from August 2003 to March 2004 who received N2O for PSA were eligible for enrolment. The only formal exclusion criteria was the use of additional sedative agents cheap oakley sunglasses.