To Nitrous or No?

 

Recently our city's university health system has developed a protocol for the use of Nitrous Oxide in labor.  Yay!   You may remember its use being depicted in a certain famous British television program about midwives.  In fact in England Nitrous Oxide is commonly used as an anesthetic during labor. With a few exceptions, it is known to be reliably helpful for getting moms through the hardest part of a contraction, but is this because of a chemical effect? Or another reason that MAY surprise you?

Nitrous does not reduce the amount of pain you're in, but it does act to "dull the pain receptors" temporarily*.  In hospital use, Nitrous Oxide helps a mother RELAX, and it is relaxation that has a great deal to do with reducing pain.  In fact, I proclaim relaxation relief is comparable to that offered by any drug.  Do yourself a favor and stop reading this blog post for a little bit.  Let that last statement sink in...

from thedrugclassroom.com

from thedrugclassroom.com

 

Ready?...  Good.   Here's some quick facts about Nitrous Oxide and some things to consider before deciding whether to try the "relative analgesia" or "hippie crack" as it's sometimes been called.

  • In common maternity protocols, the Nitrous Oxide gas is self administered. You can take the mask on and off as you desire.
  • Tingling on face and extremities, warmth, relaxation, and even euphoria are often reported IN ADDITION to pain reduction.
  • Because it occurs naturally in the atmosphere, Nitrous Oxide has a half life of about 5 minutes depending on the mixture. It also leaves the body essentially unmetabolized via the lungs.
  • Because of the above point, the effect is very temporary.
  • Because of the above point, the user typically desires a second or third application quickly.
  • This is essentially the same drug/concept commonly known as a "whippet" - which has other potential side effects when used recreationally.
  • While experiencing the core effect, some respiration may be decreased- your care provider will monitor this closely probably with a pulseoximiter.
  • In medical settings the gas is administered WITH oxygen. (I've read 50-50 but your situation may vary).
  • Patients with pre-existing respritory complications (COPD, pneumothorax) or other conditions where air-filled cavities may expand radically may want to speak to their doctor about whether they are appropriate candidates for this option.
  • Patients with the gene mutation called MTHFR  need to seriously consider potential complications with Nitrous Oxide.  Essentially, in a person with MTHFR, Nitrous Oxide can interfere with the conversion of folic acid into usable form (which is vital for all sorts of functions in the body).

AHWONN ( Association of Women’s Health, Obstetric & Neonatal Nurses) has a pretty good overview of the use of Nitrous Oxide in labor- you should check that out too.  Annnd of course speak to your care provider to get ALL applicable information BEFORE labor if this is a pain relief option that interests you.

It's good to have choices.  It's good to know all about what those choices are before you make them.

 

 

http://emedicine.medscape.com/article/1413427-overview#a3

*https://www.nursingtimes.net/clinical-archive/pain-management/using-nitrous-oxide-and-oxygen-to-control-pain-in-primary-care/1852366.article

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3594866/

http://www.rochesterfirst.com/news/video/urmc-to-offer-nitrous-oxide-during-child-birth_20170925213107/818366916

 

UPDATE OCTOBER 13th 2017- This just in, "Nitrous isn't all it's cracked up to be."