Methods: This will be a prospective randomized controlled trial conducted in the JMC PED. Children 3-12 years of age presenting to the PED, who require a minor procedure will be assessed for eligibility. Minor procedures will be defined as any procedure in which the standard management may involve providing local anesthetic and/or holding the child in order to successfully accomplish the procedure. These are not procedures in which the patient would receive parenteral analgesics, anxiolytics or anesthetics, because they are minimally painful and do not warrant the potential risks associated with parenteral anesthesia. Examples of minor procedures include simple incision and drainage of an abscess, intravenous catheter placement, urinary catheter placement, paronychia incision, foreign body removal and simple laceration repair. A local anesthetic such as injectable lidocaine or a topical anesthetic such as Eutectic Mixture of Local Anesthetics (EMLA) is frequently used and their use will be at the discretion of the provider performing the procedure. The doses of the topical anesthetics used are uniform. The decision of whether topical anesthesia will be used will be made by the provider before group randomization of the patient. Exclusion criteria include patients with medical conditions in which nitrous oxide is contraindicated, who are unable to communicate reliable levels of pain or who have low-to-no anxiety levels demonstrable by a validated anxiety scale, scored in the examining room by a research assistant after the procedure is described by the provider. After obtaining parental consent/child assent, patients will be randomized using a random number table to group 1 (nitrous oxide plus standard management) or group 2 (standard management alone). Because younger children especially experience significant anxiety before and during procedures, which can negatively affect the success of the procedure, we will use block randomization by groups of 6 for two separate age groups in order to ensure equal representation in both groups. These groups will be divided into preschool age (3 years to <6 years) and school age (>6 years- 12 years) children. Patients in the nitrous oxide group will receive nitrous oxide up to 70% concentration using a nitrous oxide protocol previously developed for use in the PED (attached), along with standard management (+/- local anesthetic, +/- holding the child) as determined by the provider prior to randomization. Patients in Group 2 will receive standard management alone (+/-local anesthetic, +/- holding the child).