Updated 26 October 2016

Epidural better than 'laughing gas' for labour pain

Nitrous oxide ('laughing gas') is becoming more widely available in the United States, but the majority of patients still end up requesting an epidural.


Most women who choose so-called laughing gas to control pain while giving birth eventually ask for an epidural anyway, a new study finds.

'Somewhat helpful'

Laughing gas (nitrous oxide) is an inhaled anaesthetic commonly used to manage labour pain in a number of countries. The gas reduces anxiety and makes patients less aware of pain, researchers said.

"Nitrous oxide is gaining interest among expectant mothers as an option to manage labour pain and is becoming more widely available in the United States," said lead investigator Dr Caitlin Sutton, an obstetric anaesthesiology fellow at Stanford University School of Medicine in Palo Alto, California.

"However, we found that for the majority of patients, nitrous oxide does not prevent them from requesting an epidural. While nitrous oxide may be somewhat helpful, epidural anaesthesia remains the most effective method for managing labour pain," she added.

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Epidural anaesthesia is generally administered through a tube placed into the lower back, into the space below the spinal cord. It blocks pain in the lower part of the body so a woman can be awake and alert during delivery. It is the most common type of labour pain relief used in the United States, the study authors said.

In the study, the researchers reviewed the medical records of nearly 4,700 women who delivered vaginally at a US obstetrics centre between September 2014 and September 2015. Only 148 of the women chose nitrous oxide to manage their labour pain.

Further research needed

On average, the pain score immediately before receiving nitrous oxide was 8 on a scale from 0 to 10, and that score remained the same after receiving nitrous oxide. The average length of time that nitrous oxide was used was 80 minutes.

Sixty percent of the women who used nitrous oxide eventually decided to get an epidural anyway, according to the study.

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The research was to be presented at the annual meeting of the American Society of Anaesthesiologists (ASA), in Chicago.

Further research is needed to determine which women would most benefit from nitrous oxide during labour, Sutton said.

"Knowing which patients are more likely to convert from nitrous oxide to an epidural can help physician anaesthesiologists offer more individualised counselling to patients when they are in labour," she explained in an ASA news release.

Research presented at medical meetings is considered preliminary until published in a peer-reviewed journal.

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