Nitrous Oxide for the Management of Labor Pain

Likis, Frances E; Andrews, Jeffrey C; Collins, Michelle; Lewis, Rashonda M; Seroogy, Jeffrey J; Starr, Sarah A.; Walden, Rachel R.; McPheeters, Melissa L

doi:10.1213/ane.0b013e3182a7f73c

Cited by 131 publications

(105 citation statements)

References 56 publications

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“…The use of nitrous oxide may be an ideal adjunct in this situation. 38 However, although common in other countries, nitrous oxide is currently only rarely available in the US for labor analgesia. Various medical staff (e.g., nurses) and nonmedical support personnel (e.g., trained birth attendants such as doulas) may be resources in collaborative efforts to ensure that women in labor receive patient-centered pain management care.…”

Section: Discussionmentioning

confidence: 99%

Women’s Experiences with Neuraxial Labor Analgesia in the Listening to Mothers II Survey

Attanasio

Kozhimannil

Jou

et al. 2015

Anesthesia &Amp; Analgesia

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Background Most women who give birth in United States (US) hospitals receive neuraxial analgesia to manage pain during labor. In this analysis we examined themes of the patient experience of neuraxial analgesia among a national sample of US mothers. Methods Data are from the Listening to Mothers II survey, conducted among a national sample of women who delivered a singleton baby in a US hospital in 2005 (N=1,573). Our study population consisted of women who experienced labor, did not deliver by planned cesarean, and who reported neuraxial analgesia use (n = 914). We analyzed open-ended responses about the best and worst parts of women’s birth experiences for themes related to neuraxial analgesia using qualitative content analysis. Results Thirty-three percent of women (n=300) mentioned neuraxial analgesia in their open-ended responses. We found that effective pain relief was frequently spontaneously mentioned as a key positive theme in women’s experiences with neuraxial analgesia. However, some women perceived timing-related challenges with neuraxial analgesia, including waiting in pain for neuraxial analgesia, receiving neuraxial analgesia too late in labor, or feeling that the pain relief from neuraxial analgesia wore off too soon, as negative aspects. Other themes in women’s experiences with neuraxial analgesia were information and consent, adverse effects of neuraxial analgesia, and plans and expectations. Conclusion Findings from this analysis underscored the fact that women appreciate the effective pain relief that neuraxial analgesia provides during childbirth. While pain control was one important facet of women’s experiences with neuraxial analgesia, their experiences were also influenced by other factors. Anesthesiologists can work with obstetric clinicians, nurses, childbirth educators, and with pregnant and laboring patients to help mitigate some of the challenges with timing, communication, neuraxial analgesia administration, or expectations that may have contributed to negative aspects of women’s birth experiences.

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Section: Discussionmentioning

confidence: 99%

Women’s Experiences with Neuraxial Labor Analgesia in the Listening to Mothers II Survey

Attanasio

Kozhimannil

Jou

et al. 2015

Anesthesia &Amp; Analgesia

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“…8 Most studies have not found adverse outcomes in the babies of mothers using nitrous oxide for labour but the quality of the studies has been poor. APGAR scores are no different between babies born to mothers who used nitrous oxide for labour and those mothers who used other or no pharmacological labour analgesia.…”

Section: Learning Objectivesmentioning

confidence: 99%

Non-neuraxial analgesia in labour

Robinson¹,

Howie²

2016

Anaesthesia & Intensive Care Medicine

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Pain in labour is often described as one of the most severe pains experienced. Neuraxial techniques provide the most effective form of labour analgesia. However, not all women wish to have this or indeed want complete pain relief in labour. There are also subgroups of women in whom neuraxial techniques are contraindicated or attempted placement is unsuccessful. Therefore delivery units must be able to offer a range of non-neuraxial analgesia options for labour. Royal College of Anaesthetists CPD Matrix: 1A02, 1D02, 2B01Women in labour expect to have effective analgesia and are disappointed when this is not the case. The degree of analgesia desired varies widely, with two-thirds of women questioned wanting the minimum amount of drugs to allow them to cope with the pain of labour. 1 It is therefore important that we are able to offer a range of analgesic options and ensure we give goodquality information about the different options available to aid women in making a choice most appropriate to their needs. This article will focus on non-neuraxial techniques of analgesia: non-pharmacological and pharmacological (Table 1). Non-pharmacologicalLabouring women use a range of non-pharmacological techniques for pain relief with varying effects and evidence for their use. There is some evidence to support the use of relaxation, immersion in water, acupuncture and massage, but insufficient evidence for the use of transcutaneous electrical nerve stimulation (TENS), sterile water injections, aromatherapy, biofeedback and hypnotherapy. 2 Even the techniques with poor evidence of efficacy are found useful by many women and can improve maternal satisfaction. RelaxationRelaxation techniques (breathing exercises) are often taught in antenatal classes. By focussing on breathing, it helps women to stay in control and conserve energy. Relaxation techniques are thought to provide analgesia and better maternal satisfaction with childbirth. 3

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“…El óxido nitroso 49 , de inicio rápido (50 seg), se puede usar en cualquier fase del parto 36 . Se elimina rápidamente de los pulmones y no causa depresión neonatal 50,51 .…”

Section: Fármacos Inhalatoriosunclassified

Técnicas analgésicas para el parto: alternativas en caso de fallo de la epidural

Ortiz-Gómez

Palacio-Abizanda

Fornet-Ruiz

2014

Anales Sis San Navarra

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Se insiste en la necesidad de aplicar una aproximación terapéutica multifactorial a la embarazada, no limitándonos solo a eliminar el dolor del parto.Palabras clave: Analgesia obstétrica. Dolor del parto. Epidural. Analgesia controlada por el paciente. Remifentanilo. AbsTrAcTEpidural analgesia is now the method of choice for the treatment of pain in labour and delivery. However, this technique may fail and provide inadequate or null alleviation to the mother. This paper reviews the risk factors, possible causes and possible therapeutic alternatives to inadequate analgesia, whether pharmacological therapies (neuroaxial, peripheral blocks or analgesic administration via intravenous or inhalational routes) or non-pharmacological ones (relaxation techniques, psychological or mechanical).In all possible cases the efficacy and indications of alternative therapies based on the published literature are reviewed, especially from the point of view of evidence-based medicine.The need is underscored of a multifactorial therapeutic approach to the pregnant woman, not just restricting ourselves to eliminating the pain of childbirth.

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Nitrous Oxide for the Management of Labor Pain

Abstract: The literature addressing nitrous oxide for the management of labor pain includes few studies of good or fair quality. Further research is needed across all of the areas examined: effectiveness, satisfaction, and adverse effects.

Cited by 131 publications

References 56 publications

Women’s Experiences with Neuraxial Labor Analgesia in the Listening to Mothers II Survey

Women’s Experiences with Neuraxial Labor Analgesia in the Listening to Mothers II Survey

Non-neuraxial analgesia in labour

Técnicas analgésicas para el parto: alternativas en caso de fallo de la epidural

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