Does nitrous oxide help with pain

Nitrous oxide for labor: Seriously, don’t laugh before you read this | Your Pregnancy Matters

We’ve all heard of nitrous oxide, or “laughing gas.” Usually we think of it in the context of dental procedures, but did you know nitrous oxide has a place in labor and delivery? It’s true – nitrous oxide for labor analgesia (pain relief during labor) has been around for over 50 years.

The first recorded use of nitrous oxide was in Poland in 1881. Since the development of the delivery system in the mid-1900s, it has been continually available for use during labor in the UK and other Western countries and has remained a popular option among laboring mothers there.

Nitrous oxide has been used in the US, as well; however, with the development and ensuing popularity of neuraxial anesthesia (popularly referred to as an epidural) in the 1970s, interest in nitrous oxide waned in the United States and was abandoned on most labor and delivery units. In some areas of the country, however, nitrous oxide has been continually available and remains a popular option.

In the past decade, American interest in using the gas during labor has been on the rise. Let’s learn more about nitrous oxide as an option during labor.

What is nitrous oxide?

Nitrous oxide (N2O) is a nonflammable, colorless gas. Although generally considered odorless, there is a faintly pleasant sweet sensation when inhaled. Nitrous oxide does not actually reduce pain or take away the sensation of a contraction, like an epidural. Instead, it relieves anxiety, which helps in the tolerance of pain.

If you have ever had a dental procedure, you may recall that you still felt the needle when the dentist administered the local anesthetic; you probably just didn’t feel like you cared about it as much as you would have without the gas.

In the U.S., the NITRONOX® system has FDA approval for delivery of a stable 50/50 mix of nitrous oxide and oxygen. The gas is self-administered via a facemask you hold in place. When you inhale, a valve allows the gas to be released, and when you exhale the system has a separate scavenging tube that captures the exhaled gas and prevents it from being released into the room and affecting the people around you. The effects clear quickly when you resume breathing room air.

Reported side effects include a floating or “cloud 9” sensation, which can lead to vertigo. Some people experience nausea, but it is not associated with increased vomiting during labor. There are no effects on uterine activity or fetal heart rate, and nitrous oxide does not result in sedation of the newborn.

The American Society of Anesthesiologists classifies nitrous oxide as “minimal sedation” because the user remains responsive and maintains control of her own airway and ventilation and cardiovascular function is not impaired.

How do you use nitrous oxide during labor?

Anecdotal reports suggest nitrous oxide works best when women start breathing it in about 30 to 60 seconds before their next contraction so the peak effect of the gas occurs during the peak of the contraction. This is not an exact process, especially in early labor when contractions may not be regular or predictable. Studies have shown nitrous oxide has an analgesic effect similar to short-acting patient-administered narcotics, such as an IV PCA pump.

Nitrous oxide can be used during any stage of labor or after the delivery if there is need for repair of a laceration or manual extraction of retained placenta. Because the effects wane so quickly, converting to another form of anesthesia can be done without delay. Nitrous oxide can even be used during epidural placement.

The American College of Nurse Midwives, in a 2009 statement, advocated for availability of the gas and recommended that, when available, midwives be trained to oversee its safe use. The American College of Obstetricians and Gynecologists has not issued a statement regarding the use of nitrous oxide in pregnancy.

Who would be a good candidate for nitrous oxide during labor?

Nitrous oxide has many benefits and few contraindications (your doctor will go over those if you ask about using it). It can be initiated quickly, making it a great choice for women in advanced labor who just need a little help to get through delivery.

The rapid onset and clearance are also great features for women who labored without analgesia but need a post-delivery procedure.

Ok, I’m not laughing anymore, but what else should I take into consideration?

Because nitrous oxide has to be administered via facemask, it’s probably not the best option if you struggle with claustrophobia. For safety reasons, the facemask cannot be secured with a strap or any other device that holds it in place. If you present in early labor with your first pregnancy, it may be a long time until delivery. While not contraindicated, having to use the mask over and over for many hours may get tiring. Due to risk for fall, as well as the obvious need to be close to the mask, you cannot use nitrous oxide while walking or moving around during early labor.

Because nitrous oxide is cleared via the lungs, it’s also not recommended for women with severe chronic obstructive pulmonary disease (COPD) or any severe upper airway obstruction (this does not include mild asthma). Women known to have B12 deficiency or pernicious anemia, as well as those known to have an MTHFR gene mutation, should not use nitrous oxide in labor. While nitrous oxide has been used for years in Europe with no observed immediate effect on the newborn, there are no long-term studies.

My best advice would be to start with the hospital where you plan to deliver. Although nitrous oxide is becoming more popular and available, it is still not widely available in the Dallas area. If it is an option at your delivery facility, discuss it ahead of time with your OB or CNM because they know you best.

For more information about pregnancy, labor, and delivery, sign up to receive Your Pregnancy Matters email alerts when we publish new stories. You can also make an appointment to see one of our specialists by calling 214-645-8300.

Nitrous Oxide Vs. Other Pain Relief Options

As you consider your pain relief options for labor and delivery, have you compared your options side-by-side to see the differences?

At Moreland OB-GYN, our experienced obstetricians want to make sure you feel informed of your options so you can make the best pain-relief choice for your delivery.

Our newest labor and delivery pain relief option, the use of nitrous oxide, has spurred a number of questions. Keep reading to learn more, and to compare pain relief options to find the right fit for you!

Laughing Gas During Labor?

We know what you might be thinking -- “laughing gas, during labor?” We understand, and here are some more questions we often here:

• Does laughing gas make you laugh? No.
• Is laughing gas safe? Yes, very safe.
• What are the side effects of laughing gas? Very minimal, often just mild nausea.

The truth is, laughing gas (or nitrous oxide) has a bad reputation, mostly associated with YouTube videos of individuals after dental appointments. But the nitrous oxide that obstetricians use during labor and delivery is much less concentrated than the type of gas used in dental offices. As a result, there are very minimal side effects from nitrous oxide and they wear off in as little as 10-15 minutes.

Learn more about the side effects of nitrous oxide now.

How Does Nitrous Oxide Help With Pain?

Nitrous oxide is an effective pain relief option for many women during labor and delivery because it helps to promote relaxation while reducing both pain and anxiety. Some women choose to use it in early labor to relieve pain and anxiety, then choose an alternative option, like an epidural, during active labor, and some women use it throughout their delivery.

Can you still feel pain with laughing gas?

It’s really up to you to control your own pain relief with nitrous oxide. It doesn’t eliminate all pain and sensation, but some women find it very effective to help ease anxiety and promote relaxation.

By placing the mask on your face, you can inhale nitrous oxide to feel the pain-relieving effects. Once you remove the mask, the effects begin to wear off almost immediately.

• Nitrous oxide is short-acting
• It is often used as a transitional medicine, to ease anxiety and pain during cervical checks or before a patient decides they’d like an epidural
• Nitrous oxide can be effective when your labor has progressed too far for other interventions, like an epidural

A Doctor’s Own Experience with Nitrous Oxide

Stephanie Voice, D. O., a physician at Moreland OB-GYN, successfully used nitrous oxide during the labor and delivery of her first child out-of-state. Once she reached 5cm dilation, she wanted a pain relief option that would allow her to maintain control and the ability to move around.

“As a patient, I wanted to maintain mobility, and the ability to re-position for as long as possible,” stated Dr. Voice. “I could breathe in the mask when I felt a contraction coming on and it provided pain relief and a feeling of relaxation.”

Dr. Voice is an advocate of using nitrous oxide to help transition to other pain relief options as well, like an epidural.

“During my labor, I successfully used nitrous oxide until a certain point when I knew I wanted an epidural,” she stated. “The transition was seamless and there were no side effects from the nitrous oxide. I would recommend it to all of my patients who are good candidates.”

Nitrous Oxide vs. Other Pain Relief Options

There are many effective pain relief options for women in labor. A combination of your personal preferences and your doctor’s recommendation can help you determine the best labor pain relief option for you. Review the chart below to learn more about what services are available to you and the pros and cons of each.

Learn more about pain relief during labor.

We encourage you to learn more about nitrous oxide with our free resources or request an appointment with a Moreland OB-GYN doctor to talk more about the right pain relief options for your delivery.

At Moreland OB-GYN, we specialize in women’s health care and prioritizing the needs of our patients. We hope you’ll connect with us to answer your questions and we hope you’ll turn to our experts as a trusted source for information.

Learn more about the doctors at Moreland OB-GYN who offer Nitrous Oxide treatment in Waukesha, Oconomowoc, Lake Country, Milwaukee, and the surrounding areas.

Dental treatment for children in sedation (nitrous oxide) in Moscow

We regularly go for preventive examinations, thanks to which everything is fine with the teeth! the child is happy to go to the doctor. We also picked up a toothpaste for hygiene. 2 teeth were treated (caries at an early stage) under gas - it went easily and painlessly. Eldar Vilevich easily finds an approach to the child, the treatment is easy, only pleasant impressions. The child is always happy to go to the doctor. nine0004

TEAM DENTAL FANTASY: Anastasia, thank you for your feedback! We are very happy to hear that the child is happy to go to the dentist! This positive attitude is very important. We send you greetings from the doctor and wish you good health!

A wonderful professional in his field, who knows the approach to children, endearing to himself. We are very satisfied, we have treated several teeth under nitrous oxide, each tooth is about an hour. The child is satisfied, often remembers "Uncle Eldar" and general topics). We are grateful and highly recommend Eldar Vilevich to everyone. Very attentive, super competent, friendly doctor. Thank you very much for the beautiful smile of my son)! nine0004

TEAM DENTAL FANTASY: thank you for your feedback about the doctor! It's good that your son now has a dentist friend :) Good health and many reasons to smile!

12.02 were treated by Melnik N.A. under the tinder. The son is happy, anxiety is at zero. He survived a whole hour in the chair without any problems, for which he received a lot of praise and support from the doctor. The son is at a loss why it didn’t hurt, because Dental Fantasy does not give injections, and he had anxious expectations after a negative experience in another dentistry. There is still dental treatment ahead, we will definitely come. nine0004

TEAM DENTAL FANTASY: we are so happy that we were able to treat your son without stress and change his attitude towards dentists! Thank you very much for writing us a review! We are waiting for you to continue treatment!

I want to express my boundless gratitude and appreciation to the wonderful doctor Cherepkova Yulia Sergeevna, for her professionalism and fantastic approach to children. Our story is this: after a negative experience of dental treatment for a 4-year-old son in another network clinic, I was simply horrified when the child's filling fell out again. He had a panic fear, and I was worried that he would never allow even a single dentist to conduct an examination, not to mention treatment. But in Dental Fantasy we found ourselves in a fairy tale, a wonderful atmosphere, no children's tears and a sensitive doctor who reassured us that they would not do anything by force. The son, of course, was shaking with fear, lying in a chair, but Yulia Sergeevna was able to find an approach to our baby. A week later, we arrived at the adaptation, the son made contact and even let me do some manipulations, he skipped running for the 2nd adaptation visit, and asked for the 3rd one himself, because a visit to the clinic is a whole adventure: animators, gifts, and even in the office a lot of interesting and magical doctor. This is such an amazing metamorphosis. In 1.5 months from the first visit, we healed 5 teeth, while on the last visit we treated 2 at once under nitrous oxide, the son lay cross-legged, watched cartoons and was absolutely calm. Bravo! Yulia Sergeevna, you are a real sorceress, thank you for your work! P.S. Many thanks to the assistant doctor for the well-coordinated work. nine0004

TEAM DENTAL FANTASY: thank you so much for your kind words, for such a detailed story! It's good that the doctor found an approach to your son! Now everything will be fine. Yes, Yuliya Sergeevna is an excellent doctor and a real sorceress, I agree with you :)

Nitrogen dental treatment for children and adults. Sedation with nitrous oxide for children

Author-physician:
Fanakin Vitaly Aleksandrovich

Candidate of Medical Sciences, orthopedic dentist, member of the Medical Council of the STOMPRAKTIKA.RF clinic network, chief physician of the clinic, implant surgeon, head of the department, dental surgeon

Date of publication of the article: 07 December 2020

Dental treatment with nitrous oxide

What is nitrous oxide?

Indications for use

The main contraindications

Advantages of sedation

Sedation for children

What is the treatment of teeth with nitrogen

How to prepare for sedation

difference between sedation and anesthesia

If you want your child to have a good first visit to the dentist, you can try nitrous oxide treatment. In European countries, this technique is used in 9 cases out of 10. In Russia, it is much less common. What are the pros and cons of dental treatment with nitrous oxide? Is it harmful to the body? What are the indications and contraindications?

What is nitrous oxide?

Nitrous oxide (oxygen sedation or laughing gas) is a tasteless and odorless gas. It causes a calming effect, reduces sensitivity and anxiety levels. In our clinic, oxygen sedation is used for adults and children from 3 years of age. Why exactly 3 years? Because at a younger age, the child may not understand the doctor's request and, accordingly, cannot fulfill it. nine0004

Indications for use

Who is sedated dental treatment recommended for?

• Who has an overwhelming fear of dental treatment.
• Who has an increased gag or cough reflex.
• Children aged 3 years and over, especially if this is the first dental appointment.

Main contraindications

• Individual intolerance.
• SARS or diseases of the nasopharynx.
• Recent head trauma.
• Convulsions and epilepsy.
• Excessive panic and fear.

Benefits of sedation

• Safety . Nitrous oxide does not cause allergies and is quickly excreted from the body.
• Comfort. The child is completely relaxed, he is not distracted by manipulations and unpleasant odors.
• Calmness Sedation removes the manifestation of fear. This is especially true for small patients who cannot sit in one place for more than five minutes. Sedation allows for treatment that lasts about an hour and reduces the number of visits to the doctor. nine0092

Sedation for children

The use of nitrous oxide soothes children who are very anxious in the dentist's chair and prevent proper treatment. However, sedation is not considered an alternative to anesthesia, as it has a slight analgesic effect, but does not completely relieve pain. The doctor gives an injection with an anesthetic after the sedation has begun to take effect, so the child practically does not feel anything.

It is important to understand that in the case of dental panic, not sedating is much more harmful than using it. The child may experience psychological trauma, which sometimes leads to more serious problems and even stuttering. nine0007