Nitrous oxide for the management of labor pain

OBJECTIVES: The Vanderbilt Evidence-based Practice Center systematically reviewed evidence addressing the use of nitrous oxide for the management of labor pain. DATA SOURCES: We searched the MEDLINE(r), Embase, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases for artic...

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Bibliographic Details
Main Author: Likis, Frances E.
Corporate Authors: United States Agency for Healthcare Research and Quality, Vanderbilt Evidence-based Practice Center, Effective Health Care Program (U.S.)
Format: eBook
Language:English
Published: [Rockville, Md. Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services 2012, 2012]
Series:Comparative effectiveness review
Subjects:
Online Access:
Collection: National Center for Biotechnology Information - Collection details see MPG.ReNa
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100 1 |a Likis, Frances E. 
245 0 0 |a Nitrous oxide for the management of labor pain  |h Elektronische Ressource  |c prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Vanderbilt Evidence-based Practice Center ; investigators, Frances E. Likis ... [et al.] 
260 |a [Rockville, Md.  |b Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services  |c 2012, 2012] 
300 |a 1 PDF file (1 v. (various pagings)  |b ill.) 
505 0 |a Includes bibliographical references 
653 |a Comparative Effectiveness Research 
653 |a Nitrous Oxide / therapeutic use 
653 |a Labor Pain / therapy 
653 |a Treatment Outcome 
710 2 |a United States  |b Agency for Healthcare Research and Quality 
710 2 |a Vanderbilt Evidence-based Practice Center 
710 2 |a Effective Health Care Program (U.S.) 
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989 |b NCBI  |a National Center for Biotechnology Information 
490 0 |a Comparative effectiveness review 
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520 |a OBJECTIVES: The Vanderbilt Evidence-based Practice Center systematically reviewed evidence addressing the use of nitrous oxide for the management of labor pain. DATA SOURCES: We searched the MEDLINE(r), Embase, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases for articles published in English. REVIEW METHODS: We excluded studies that did not address a Key Question, were not original research, or had fewer than 20 participants. We identified a total of 58 publications, representing 59 distinct study populations: 2 of good quality, 11 fair, and 46 poor. RESULTS: Inhalation of nitrous oxide provided less effective pain relief than epidural analgesia, but the quality of studies was predominately poor. The heterogeneous outcomes used to assess women's satisfaction with their birth experience and labor pain management made synthesis of studies difficult. The strength of evidence was insufficient to determine the effect of nitrous oxide on route of birth. Most maternal harms reported in the literature were unpleasant side effects that affect tolerability (e.g., nausea, vomiting, dizziness, and drowsiness). Apgar scores in newborns whose mothers used nitrous oxide were similar to those of newborns whose mothers used other labor pain management methods or no analgesia. Evidence about occupational harms and exposure was limited. CONCLUSIONS: The literature addressing nitrous oxide for the management of labor pain has few studies of good or fair quality. Synthesis of effectiveness and satisfaction studies is challenging because of heterogeneous interventions, comparators, and outcome measures. Research assessing nitrous oxide is needed across all of the Key Questions addressed: effectiveness, women's satisfaction, route of birth, harms, and health system factors affecting use