Nitrous Oxide for Labor Analgesia: What We Know to Date
Kirbie Broughton1, Allison G Clark1,2, Adrienne P Ray1
1Department of Anesthesiology, Ochsner Clinic Foundation, New Orleans, LA.
Ochsner Journal
|January 7, 2021
Summary
Nitrous oxide (N2O) is increasingly used for labor analgesia in the US. While less potent than epidurals, it provides a safe option for women seeking more control during childbirth.
Area of Science:
- Obstetrics and Gynecology
- Pain Management
- Anesthesiology
Background:
- Nitrous oxide (N2O) has a long history for labor analgesia but has seen a significant resurgence in US hospitals since 2011.
- Its adoption has grown from only 3 centers in 2011 to several hundred by 2020, indicating increased clinical interest.
Purpose of the Study:
- To review the literature on nitrous oxide (N2O) for labor analgesia.
- To summarize its mechanism of action, clinical applications, efficacy, and patient satisfaction.
- To assess its role as a safe alternative for laboring women.
Main Methods:
- A comprehensive literature review was conducted.
- The review focused on the proposed mechanisms of action, clinical uses, and efficacy of N2O.
- Patient satisfaction data and safety profiles for mother and infant were also analyzed.
Main Results:
- Nitrous oxide (N2O) is considered viable for all stages of labor and postpartum procedures due to its proposed mechanisms.
- Evidence supports N2O as a safe analgesic for both mother and baby during labor and delivery.
- While 40-60% of women transition to epidural analgesia, satisfaction surveys highlight factors beyond pain relief, such as control and mobility.
Conclusions:
- The use of nitrous oxide (N2O) in US labor and delivery units has markedly increased since 2011.
- N2O presents a safe alternative to epidural analgesia for laboring women.
- It empowers patients desiring enhanced control and mobility during childbirth, despite having less potent analgesic effects than epidurals.
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