Pro-Con Debate: Nitrous Oxide for Labor Analgesia.
Manuel C Vallejo1, Mark I Zakowski2
1West Virginia University, Morgantown, WV 26506, USA.
Biomed Research International
|September 19, 2019
Summary
Nitrous oxide for labor analgesia may pose risks. Emerging evidence suggests potential adverse maternal and fetal effects, prompting a re-evaluation of its use during childbirth.
Area of Science:
- Obstetrics and Gynecology
- Anesthesiology
- Reproductive Toxicology
Background:
- Nitrous oxide is a long-established agent for analgesia in dental and medical settings.
- Historically considered safe, recent evidence highlights potential adverse effects in pregnant women.
- Reconsideration of its use in obstetrics is prompted by new preclinical and clinical findings.
Purpose of the Study:
- To present an evidence-based Pro-Con debate on using nitrous oxide for labor analgesia.
- To inform clinicians on the risks and benefits of nitrous oxide in the obstetrical suite.
- To guide decision-making regarding the employment of this labor analgesia technique.
Main Methods:
- Review of accumulating preclinical and clinical evidence on nitrous oxide's effects.
- Discussion of the advantages and disadvantages of nitrous oxide in labor analgesia.
- Examination of specific concerns including metabolic, oxidative, genotoxic, and epigenetic effects.
Main Results:
- Nitrous oxide is linked to metabolic, oxidative, genotoxic, and transgenerational epigenetic effects in animal and human studies.
- Concerns exist regarding occupational exposure, neuroapoptosis, and effects on the developing brain.
- FDA warnings on inhalational anesthetics and the developing brain are relevant to nitrous oxide use.
Conclusions:
- The potential adverse maternal and fetal effects necessitate a re-evaluation of nitrous oxide for labor analgesia.
- Informed consent processes should be more detailed, addressing newly recognized risks.
- Further research is needed, alongside consideration of occupational safety limits and environmental impact.
Related Concept Videos
14:52Recording Brain Electromagnetic Activity During the Administration of the Gaseous Anesthetic Agents Xenon and Nitrous Oxide in Healthy Volunteers
11.4K
Simultaneous magnetoencephalography and electroencephalography provides a useful tool to search for common and distinct macro-scale mechanisms of reductions in consciousness induced by different anesthetics. This paper illustrates the empirical methods underlying the recording of such data from healthy humans during N-Methyl-D-Aspartate-(NMDA)-receptor-antagonist-based anesthesia during inhalation of nitrous oxide and xenon.
11.4K
01:25Analgesia and Pain Management
1.5K
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
1.5K
03:14Oxidation Numbers
42.2K
In redox reactions, the transfer of electrons occurs between reacting species. Electron transfer is described by a hypothetical number called the oxidation number (or oxidation state). It represents the effective charge of an atom or element, which is assigned using a set of rules.
42.2K
05:50Eusociality and Division of Labor
7.9K
Social Organization
7.9K
09:03Assessment of Methane and Nitrous Oxide Fluxes from Paddy Field by Means of Static Closed Chambers Maintaining Plants Within Headspace
13.0K
The overall goal of this protocol is to measure greenhouse gas emissions from paddy fields using the static closed chamber technique. The measurement system needs specific adjustments due to the presence of both a permanent water layer in the field and of the plants within the chamber...
13.0K
01:15Pyruvate Oxidation
168.4K
After glycolysis, the charged pyruvate molecules enter the mitochondria via active transport and undergo three enzymatic reactions. These reactions ensure that pyruvate can enter the next metabolic pathway so that energy stored in the pyruvate molecules can be harnessed by the cells.
First, the enzyme pyruvate dehydrogenase removes the carboxyl group from pyruvate and releases it as carbon dioxide. The stripped molecule is then oxidized and releases electrons, which are then picked up by NAD+...
First, the enzyme pyruvate dehydrogenase removes the carboxyl group from pyruvate and releases it as carbon dioxide. The stripped molecule is then oxidized and releases electrons, which are then picked up by NAD+...
168.4K