Medical Rounds with Jennifer Moller, RN

If you’re a mother you know that labor pains are no "laughing matter"… but "laughing gas" may actually help to manage that pain. Hartford Hospital is offering mother’s nitrous oxide to reduce discomfort and anxiety often experienced during labor.

We asked Jennifer Moller, RN and Perinatal Safety Coordinator at Hartford Hospital to explain more about this option for mothers.

Q. What is nitrous oxide?
A. Nitrous oxide is an odorless, tasteless gas that is commonly used in dental offices, where most people know of it as "laughing gas". The blend that is used in laboring women is different, and does not have the same effect, as it is not anesthesia. Nitrous oxide use for labor pain is a mixture of 50% nitrous gas and 50% oxygen that is inhaled through a mask. It has been, and still is, widely used throughout the world for managing labor pain.

Q. How does nitrous oxide work to relieve pain during labor?
A. Nitrous oxide can help lessen both pain and anxiety during labor. It is self- administered by inhaling through a mask. The patient will hold her own mask or mouthpiece and begin to inhale the gas mixture about 30 seconds before a contraction begins. Starting to breathe the gas before a contraction begins helps the gas to reach its peak effect at about the same time as the contraction reaches its peak, providing the greatest relief.

Q. How will the patient feel while using nitrous oxide?
A. The patient might feel drowsy, lightheaded, or a little silly while they are using nitrous oxide. This is how it got the name "laughing gas". How well nitrous oxide works is different for every woman, but at least half of women who use it say it is helpful and they would choose to use it again. Some women say that it “takes the edge off” of the peak of the contractions, enough that they are able to cope with their labor better. Others report more pain relief. Nitrous oxide also lowers anxiety. This helps the laboring woman feel less tense during contractions, which may also help them cope with pain better. Some women do not find nitrous oxide helpful enough or do not like the way it makes them feel. They can choose to try other options to help their labor pain. Other pain relief methods can still be used after using nitrous oxide.

Q. Are there any reasons a woman should not use nitrous oxide?
A. Yes, there are some reasons or clinical indications which would bar a patient from using nitrous oxide. For example, patients cannot use nitrous oxide if they cannot hold their own mouthpiece or facemask; if they have an uncorrected vitamin B12 deficiency because using nitrous oxide could cause severe form of anemia; if they have obstructed sleep apnea; if they have a high BMI or if they have received a dose of narcotics in the previous two hours. Additionally, the nitrous oxide will be removed from the patient's room if there is any evidence that she may be sharing the nitrous oxide with others in her room. We recommend that patients who are thinking about using nitrous oxide in labor discuss the option with their provider at some point prior to coming to the hospital in labor. For their safety, patients will be reassessed upon admission to the labor and delivery unit in order to be sure they have no contraindications to the use of nitrous oxide in labor.

For more information

Visit: Nitrous Oxide for Comfort in Labor

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