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Patient Satisfaction With the Use of Nitrous Oxide for Labor Analgesia
Abstract Number: F-37
Abstract Type: Original Research
BACKGROUND: Nitrous oxide is frequently administered for labor analgesia in
several countries but is used in only a few hospitals in the United States. Some
parturients do not find nitrous oxide to be helpful or efficacious. Few
studies have assessed patient satisfaction with the use of nitrous oxide for labor
analgesia and no studies, to our knowledge, have correlated patient satisfaction with
patient demographics and obstetric parameters.
OBJECTIVE: The purpose of this study was to assess patient satisfaction with
maternal use of 50% nitrous oxide (Nitronox, Parker/Porter) for labor analgesia
and to determine if there were correlations between patient satisfaction and the
following: age, ethnicity, gestational and parity status, length of nitrous oxide use,
and cervical dilation and pain score at the start of nitrous oxide use.
METHODS: After the approval of the Institutional Review Board, this study was
conducted at the University of North Carolina Women’s Hospital in Chapel Hill, NC.
from August 1, 2014 through December 31, 2014. Forty-five women completed a
questionnaire assessing their reasons for choosing nitrous oxide, adequacy of pain
relief, reasons for discontinuation, whether they would or would not choose nitrous
oxide again, and their reasons for not choosing it again. Cervical dilation was ascertained from the intrapartum electronic medical record for the patient’s most recent cervical exam.
RESULTS: 58% of our patients used nitrous oxide until delivery (8-575 minutes).
The rest (42%) discontinued use of nitrous oxide due to inadequate pain relief (33.3%), difficulty holding the mask (9%), and drowsiness (2.2%). Twenty seven women (60%) would use nitrous oxide again and 18 women (40%) would not. The reasons women would not use nitrous oxide in the future include inadequate pain relief (78%), difficulty holding the mask (11%), dizziness (11%) and a dissociated feeling (6%). No statistically significant correlation was found between patient satisfaction and age, gestational status, parity status, ethnicity, cervical dilation at the start of nitrous oxide use, pain at the start of nitrous oxide use, and length of nitrous oxide use. Employing Wilcoxon-Mann-Whitney and Fisher tests, a statistically significant difference was noted between the perception of adequate pain relief and patient satisfaction (P=0.0009).
CONCLUSIONS: We were not able to identify patient demographic or obstetric
parameters associated with a satisfactory experience with nitrous oxide. Inadequate
pain relief was the most frequent reason patients discontinued use of nitrous and
would not use it on a subsequent labor. Other studies have shown that women who
use nitrous oxide for labor analgesia experience less labor pain than women who receive no intervention. The majority of these women experience less pain relief than women who receive an epidural. The majority of women in our study who would not use nitrous oxide again also found greater pain r