Nitrous Oxide for the Management of Labor Pain: A Systematic Review

  title={Nitrous Oxide for the Management of Labor Pain: A Systematic Review},
  author={Frances E. Likis and Jeffrey Campbell Andrews and Michelle R. Collins and Rashonda M Lewis and Jeffrey J Seroogy and Sarah A. Starr and Rachel R. Walden and Melissa McPheeters},
  journal={Anesthesia \& Analgesia},
BACKGROUND:We systematically reviewed evidence addressing the effectiveness of nitrous oxide for the management of labor pain, the influence of nitrous oxide on women’s satisfaction with their birth experience and labor pain management, and adverse effects associated with nitrous oxide for labor pain management. METHODS:We searched the MEDLINE, EMBASE, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases for articles published in English. The study population included… 
Nitrous Oxide During Labor: Maternal Satisfaction Does Not Depend Exclusively on Analgesic Effectiveness
Patients who received nitrous oxide alone were as likely to express satisfaction with anesthesia care as those who received neuraxial analgesia, even though they were less likely to report excellent analgesia.
Nitrous Oxide Use During Labor: Satisfaction, Adverse Effects, and Predictors of Conversion to Neuraxial Analgesia.
Understanding predictors of conversion from inhaled N2 O to neuraxial analgesia may assist perinatal care providers in their discussions with women about analgesia options during labor.
Initiating Intrapartum Nitrous Oxide in an Academic Hospital: Considerations and Challenges Symbol
The challenges that occurred during the process of initiating nitrous oxide for pain management during childbirth at an academic medical center are described and various committee roles are discussed.
Inhaled Nitrous Oxide Analgesia for Labor
Inhaled nitrous oxide offers a safe and effective means for labor analgesia for many women, and maternal satisfaction is not as dependent on effective pain relief as with neuraxial analgesia.
A Nurse-Directed Model for Nitrous Oxide Use During Labor
This quality improvement project involved development and implementation of a nurse-driven, self-administered, demand-flow nitrous oxide program as an option for pain relief for laboring women in a rural community hospital.
Nitrous oxide analgesia for external cephalic version: A randomized controlled trial.
Entonox® versus Pethidine in Labor Pain Relief: A Randomized Controlled Trial
Entonox® could be an alternative to pethidine for reducing labor pain, because of its efficacy, ease for self-adjustment for satisfaction, and no serious effects on the labor course and newborns.
Comfort and Satisfaction Among Women Who Used Different Options for Analgesia During Labor and Birth.


Nitrous oxide for relief of labor pain: a systematic review.
  • M. Rosen
  • Medicine
    American journal of obstetrics and gynecology
  • 2002
The nature and management of labor pain: part II. Pharmacologic pain relief.
Research is needed regarding which pain-relief options women would choose if they were offered a range of choices beyond epidural analgesia or parenteral opioids, and little evidence supports the use of one agent over another.
Safety and risks of nitrous oxide labor analgesia: a review.
  • J. Rooks
  • Medicine
    Journal of midwifery & women's health
  • 2011
Nitrous oxide labor analgesia is simple to administer, does not interfere with the release and function of endogenous oxytocin, and has no adverse effects on the normal physiology and progress of labor.
Entonox for labor pain: a randomized placebo controlled trial.
The data indicate that using nitrous oxide 50% provides significant pain relief and, although it is associated with few side effects,Nitrous oxide can be quickly implemented during advanced painful labor.
Nitrous Oxide in Early Labor Safety and Analgesic Efficacy Assessed by a Double‐blind, Placebo‐controlled Study
While intermittent self-administered 50% nitrous oxide in oxygen does not appear to predispose parturient women to hemoglobin oxygen desaturation, its analgesic effect has yet to be clearly demonstrated.
Current status of nitrous oxide for obstetric pain relief
  • L. Irestedt
  • Medicine
    Acta anaesthesiologica Scandinavica
  • 1994
Besides its use for relief of labour pain, nitrous oxide 0.5 MAC remains a common component of general anaesthesia for caesarean section and for other obstetric interventions.
The complexity of labor pain: experiences of 278 women.
The sensory (pain intensity) and effective (negative or positive experience) dimensions of pain, as well as need for pain relief during labor were explored, suggesting that coping with pain is a rewarding experience for some women.