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Papers of the Week

2020 Winter

Ochsner J



Nitrous Oxide for Labor Analgesia: What We Know to Date.


Broughton K, Clark AG, Ray AP
Ochsner J. 2020 Winter; 20(4):419-421.
PMID: 33408580.


Although nitrous oxide (NO) has been used since the 1880s for labor analgesia, its popularity has only recently increased in the United States. In 2011, only 3 centers in the country offered NO, but as of 2020, several hundred labor units have adopted its use. We reviewed the literature and summarize the mechanism of action, clinical uses, and efficacy of NO for labor analgesia, as well as patient satisfaction related to its use. NO has several proposed mechanisms of action that make it a viable option for all 3 stages of labor and postpartum procedures. NO has been shown to be a safe option for both mom and baby during labor and delivery. Studies support NO as an analgesic for laboring. Even though 40% to 60% of women who use NO convert to a labor epidural analgesia, satisfaction surveys indicate that analgesia is not the only factor contributing to the use of NO during labor. The use of NO has increased in labor and delivery units across the United States since 2011. Despite inferior analgesic properties compared to epidural analgesia, NO offers a safe alternative for many parturients who want a greater sense of control and mobility.