Use of Nitrous Oxide during Labor in an Academic Medical Center in a Rural State

Area of Science:

• Obstetrics and Gynecology
• Pain Management
• Anesthesiology

Background:

• Inhaled nitrous oxide is a self-administered, noninvasive option for labor pain relief.
• Its effectiveness and patient satisfaction are debated, with mixed research findings.
• Understanding factors influencing continued use is crucial for optimizing labor pain management.

Purpose of the Study:

• To analyze the utilization of inhaled nitrous oxide during labor.
• To identify demographic and clinical factors associated with the continued use of nitrous oxide for pain relief.

Main Methods:

• Retrospective cohort study analyzing patient charts from January 2020 to July 2023.
• Included 267 women who used nitrous oxide for labor pain management.
• Demographic and clinical characteristics were reviewed to assess usage patterns.

Main Results:

• Continued nitrous oxide use was significantly associated with management by a certified nurse midwife (aOR 2.45).
• Hispanic patients were more likely to continue nitrous oxide use.
• Non-Hispanic White (aOR 0.27) and non-Hispanic Black (aOR 0.39) women had lower odds of continued use.
• Maternal age, gestational age, marital status, insurance type, and parity were not significant factors.

Conclusions:

• Women continuing nitrous oxide until delivery were more likely to be managed by certified nurse midwives and identify as Hispanic.
• Nitrous oxide use can potentially enhance patient autonomy during labor.
• Further research is recommended to fully clarify its role in labor pain management.