Nitrous Oxide

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Does your facility use Nitrous Oxide for labor pain in place of an epidural? I know this is popular in Europe. My hospital is going to start using it, and I am curious what others' experiences have been. Also, what IV medications do you use to manage labor pains?

Specializes in ICU, Med-Surg, Float.

Like [emoji35][emoji35][emoji35] it's pushing UPHILL people!!

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it's pushing UPHILL people!!

I try to educate my patients about this, but if they haven't done their own research, most of them just look at me like I've lost it. "well, my doctor told me this is the best/most effective position for pushing, blah blah blah, my doctor is the best, blah blah blah".

I feel that anyone owning and using half a brain would know instinctively that's not the case.

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Specializes in Labor and Delivery.
I try to educate my patients about this, but if they haven't done their own research, most of them just look at me like I've lost it. "well, my doctor told me this is the best/most effective position for pushing, blah blah blah, my doctor is the best, blah blah blah".

I feel that anyone owning and using half a brain would know instinctively that's not the case.

Right?! It's amazing that some sound educated advice goes in one ear and out the other with some of these patients only because they listen to just their doctor and he/she knows best. I often will even use items to show the patient and even the support person the effects of pushing horizontal on the back and pushing in different positions that don't involve flat on the back. Sometimes then they'll listen. Luckily, most patients I have, have been open minded, but once that Doctor does come in they put the patient right back on their back! Ugh!!

I had a patient not long ago who ended up being sectioned after a couple hours of valiant pushing efforts in many different positions and it surely wasn't the docs idea. At the end she felt like she made every effort possible to have an SVD at least.

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I had a patient not long ago who ended up being sectioned after a couple hours of valiant pushing efforts in many different positions and it surely wasn't the docs idea. At the end she felt like she made every effort possible to have an SVD at least.

Absolutely! There's true failure to descend and/or failure to progress, which after a certain point is a true indicator for a c/s, but then there's "failure to descend" and "failure to progress", where a patient with a strong epidural pushes on her back for hours and hours on end to no avail. I always wonder what that would've been like if she had been offered an alternative to an epidural (like nitrous!) and been able to push in gravity-assisted positions.

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Specializes in ER.

About ten years ago I was working L&D and they thought about adding nitrous to their orificenal, but chose not to. The issue was that it is exhaled unchanged, and there was no way to eliminate it from the birthing room, everyone inside would end up high! Well clearly, someone has figured out that problem. Is there a gathering system?What was the solution?

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Specializes in ICU, Med-Surg, Float.
About ten years ago I was working L&D and they thought about adding nitrous to their orificenal, but chose not to. The issue was that it is exhaled unchanged, and there was no way to eliminate it from the birthing room, everyone inside would end up high! Well clearly, someone has figured out that problem. Is there a gathering system?What was the solution?

Really? But don't they use it in the ED for dislocations etc without everyone getting high? I've NEVER heard of that!! 🤔

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So interesting, thank you for that information! We give epidurals so much that almost all of our patients delivery on their backs. It's a pet peeve of mine

Anyone ever see a woman with an epidural deliver in a side lying position? I've often thought it would be possible but have never actually seen it done.

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Specializes in OB.
Anyone ever see a woman with an epidural deliver in a side lying position? I've often thought it would be possible but have never actually seen it done.

Yes, I do it all the time. You just need some help to hold her legs.

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Specializes in Community, OB, Nursery.
Anyone ever see a woman with an epidural deliver in a side lying position? I've often thought it would be possible but have never actually seen it done.

Did it with Thing 2!

I got my epidural at 9cm, very long story there, but I pushed/delivered her on my side. We were trying to get her head under my pubic bone, and side-lying did the trick. I can't remember who was holding my leg, if it was my L&D nurse or my husband. But I do remember was that once her head passed under the pubic bone, she practically delivered herself.

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Specializes in L&D, mother and child, antepartum, gynaecology.

we use nitrous oxide at my hospital. It can be a god send. It is fast acting and the risk for crossing the placenta is basically minimal. we use it especially with patients who dont want morphine/fentanyl or an epidural r/t risks either to babe or mom. However you have to make sure that the unit has a good ventilation system as some of the gas can escape the mask or be exhaled by the patient. there is research that states that NO2 can have cause birth affects in the first trimester and since the majority of nurses in this field are female it needs to be taken seriously.

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Specializes in Reproductive & Public Health.

I've had women with epidurals deliver in hands and knees, side lying, and squatting. If they have good mobility they can do whatever they want :)

I had the opportunity to work in a hospital that used nitrous when I was in midwifery school, and it was amazing. I had my own kids at home but if I had another, I would consider a hospital birth just to take advantage of the nitrous- and on a related note, nitrous is safe enough that UK midwives use it at home births and birth centers, and I'd love to have that option here as well!

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Specializes in Reproductive & Public Health.
we use nitrous oxide at my hospital. It can be a god send. It is fast acting and the risk for crossing the placenta is basically minimal. we use it especially with patients who dont want morphine/fentanyl or an epidural r/t risks either to babe or mom. However you have to make sure that the unit has a good ventilation system as some of the gas can escape the mask or be exhaled by the patient. there is research that states that NO2 can have cause birth affects in the first trimester and since the majority of nurses in this field are female it needs to be taken seriously.

YES. Staff exposure has to be a top priority.

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