Nitrous oxide use in labor

There is a great amount of literature exploring the effects of nitrous oxide (N2O) as a method of pain relief for laboring women. However, a majority of this research was published prior to 2010 and conducted in other countries. Since the emergence of epidural analgesia, N2O has not been the method of choice for labor pain management in the United States. Despite this trend, many hospitals have recently seen a reemergence of this less expensive and less invasive gas. Many women are choosing this method of pain relief due its benefits of having a shorter half-life, ability to encourage feelings of empowerment, and the requirement of fewer interventions that would be needed with epidural analgesia (e.g., bladder catheterization, intravenous fluid bolus, blood pressure monitoring). This gas is also an appropriate option for women if epidural analgesia is contraindicated, ineffective, or inadequate. Since this drug is self-administered by the patient, there are minimal risks of adverse effects for hospital staff and caregivers. Side effects of N2O inhalation include dizziness, nausea, vomiting, and drowsiness. Research on this intervention has not found a significant relationship between maternal N2O inhalation and neonatal APGAR scores. Overall, many studies are indicating positive benefits of N2O inhalation as a method of pain management during labor. Unfortunately, a majority of these studies were of poor quality with bias and inconsistency among expected outcomes. Furthermore, many of these studies are qualitative, gaining mothers' views of N2O use after deliveries. Clearly, further quantitative research regarding this form of pain management during labor is needed to accurately assess its effectiveness as well as the potential risks to mother, neonate, and medical staff.
Nitrous Oxide, Delivery, Obstetric, Labor Pain, Labor, Obstetric, Anesthetics, Inhalation
Nevels, K., Petsch, P. & Sevcik, E. (2019). Nitrous oxide use in labor. Poster presented at Provost Colloquium, Evidence-Based Practice Presentations, Bryan College of Health Sciences, Lincoln, NE.