Nitrous Oxide Program

Nitrous oxide as an option for labor pain

Inova Alexandria Hospital now offers nitrous oxide as an option to control labor pain. Only a handful of hospitals in the country offer this option for pain relief to laboring women. Inova Alexandria Hospital is pleased to make this option available to you!

What is nitrous oxide?

Nitrous oxide, often called "laughing gas" and widely used in dental offices to help control pain and anxiety, is also used for labor pain. The gas is a mixture of 50 percent nitrous and 50 percent oxygen, inhaled through a mask.

How does nitrous oxide work for labor

Women who decide to use nitrous oxide hold their own mask and begin to inhale the gas mixture about 30 seconds before a contraction begins. Starting to inhale before a contraction begins helps the gas to reach its peak effect at about the same time as the contraction reaches its peak, providing the greatest relief.

How is the nitrous oxide administered?

The nitrous oxide is self-administered by the laboring woman. You breathe it in as you feel the need. Once you decide to use nitrous oxide, your nurse will order it and a member of the nursing team will come to your room, set it up, and review how to use it.

Are there side effects?

Some women have reported nausea after prolonged use and medication to ease the nausea is available if needed. Use of nitrous can also cause unsteadiness when getting up. There should always be a family member or staff person in the room to assist you if you need to get out of the chair or bed.

Can I still be out of bed and use nitrous?

Because of the risk of dizziness, you must remain seated in the chair beside the bed or in the bed so that your care team can frequently monitor your blood pressure.

Is extra monitoring required?

No, there is no extra monitoring required for nitrous use. Regular monitoring will continue.

Can I use nitrous and have intravenous narcotics at the same time?

No, the combination of narcotics and nitrous can slow your breathing and would not be used together.

Are there reasons I could not use nitrous oxide?

Yes. You will not be able to use nitrous if you:

• Cannot hold your own facemask
• Have received a dose of narcotic in the past two hours
• Have pernicious anemia or a B12 deficiency for which you take B12 supplements
• Have one of a very few other rare medical conditions which a member of the anesthesia team will assess when they speak with you

Are there any effects on baby?

No, there are no known effects on the baby. Nitrous is the only pain relief method used for labor that is cleared from the body through the lungs. As soon as you pull away the mask, the nitrous effect is gone within a breath or two.

Do I have to choose nitrous oxide OR an epidural?

No. Some women use nitrous prior to having an epidural placed. Though nitrous and the epidural would not be used at the same time, it is perfectly fine to use nitrous first and then move on to a different type of pain relief if you need something else.