Abstract
Systemic opioids are widely used for the relief of labor pain. Self-administered nitrous oxide with concentration of 50% is a new form of analgesia. The aim of this study was to compare the analgesic efficacy and side effects of the patient controlled inhaled nitrous oxide (50% ‘‘Entonox’’) with systemic intramuscular pethidine, in reducing pain during normal vaginal labor in Iranian population. In a randomized controlled study, the analgesic efficacy of inhaled 50% nitrous oxide (Entonox) was evaluated as compared to intra muscular pethidine for reducing labor pain among 100 women undergoing normal vaginal delivery. Mean maternal age was 26.2 and 27.2 years in entonox and pethidine groups, respectively. Duration of first and second stages was significantly shorter in patients receiving nitrous oxide as analgesia as compared to pethidine group (P < 0.05). Pain severity according to visual analog scale (VAS) score was significantly lower in patient that received nitrous oxide (P = 0.0001). We also showed significantly higher satisfaction of pain reduction in nitrous oxide group during labor (P = 0.01). No significant difference was observed among the groups regarding neonatal complications. Although, nitrous oxide is certainly not a potent analgesic, we found that it has more beneficial effects than pethidine in parturient women which is yet to be cleared. Key words: Entonox, labor pain, pethidine, nitrous oxide.
Highlights
Labor is one of the painful conditions that is considered to be the most intense and stressful experiences (Melzack, 1984)
Duration of first and second stages was significantly shorter in patients receiving nitrous oxide as analgesia as compared to pethidine group (P < 0.05)
This study demonstrated that, using nitrous oxide (Entonox) for analgesia, causes statistically significant and clinically important reduction in severity of labor pain during first and second stages of normal vaginal delivery as compared to pethidine
Summary
Labor is one of the painful conditions that is considered to be the most intense and stressful experiences (Melzack, 1984). The number of women requesting labor analgesia is increasing, and in some communities, an effective pain relief for childbirth is in great demand (National Institute for Health and Clinical Excellence, 2008). As it is cheap, simple to use and readily available, systemic pethidine is widely used for relief of labor pain (Hawkins and Beaty, 1999; Wilson et al, 1986; Morrison et al, 1987). As pethidine crosses the placenta, it may accumulate in the fetal circulation (Gaylard et al, 1990) causing early neonatal respiratory depression and behavioral and feeding problems for even up to six weeks after delivery (Belsey et al, 1981; Belfrage et al, 1981; Nissen et al, 1997)
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