Abstract
This Pro-Con debate will provide the practitioner with an evidence-based knowledge approach to assist the clinician in determining whether to employ (Pro) or not to employ (Con) this technique in the obstetrical suite for labor analgesia. Nitrous oxide has been used safely in dentistry and medicine for many centuries. However, accumulating preclinical and clinical evidence increasingly suggests previously unrecognized adverse maternal and fetal effects of nitrous oxide, which warrants reconsideration of its use in pregnant women and a more detailed informed consent. Nitrous oxide is associated with metabolic, oxidative, genotoxic, and transgenerational epigenetic effects in animals and humans that may warrant limiting its usefulness in labor. This debate will discuss and review the clinical uses, advantages, and disadvantages of nitrous oxide on occupational effects of nitrous oxide exposure, neuroapoptosis, FDA warning on inhalational anesthetics and the developing brain, research limitations, occupational exposure safety limits, effects on global warming, and potential for diversion.
Highlights
Inhaled nitrous oxide is the most commonly used labor analgesic in many countries
The pro-nitrous oxide debate will discuss and review the clinical uses and occupational effects of nitrous oxide exposure, neuroapoptosis, Food and Drug Administration (FDA) warning on inhalational anesthetics and the developing brain, research limitations, occupational exposure safety limits, effects on global warming, and potential for diversion
Recent scientific evidence has found nitrous oxide to be associated with metabolic, oxidative, genotoxic, and transgenerational epigenetic effects in animals and humans that may warrant limiting its use in labor
Summary
Inhaled nitrous oxide is the most commonly used labor analgesic in many countries. It is used in greater than 50% of births in Finland, Norway, England, Australia, and New Zealand, 60% of births in the United Kingdom, and 70% of births in Sweden [1,2,3,4]. Nitrous oxide analgesia is gaining in popularity in the United States following approval of a delivery system by the Food and Drug Administration (FDA) in 2012 [5]. The con argument develops from the basic science mechanisms of nitrous oxide combined with the known physiologic and biochemical effects associated with its use
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
