Does nitrous oxide labor analgesia influence the pattern of neuraxial analgesia usage? An impact study at an academic medical center.

Study Objective: To compare the rate of epidural use before and after the implementation of nitrous oxide (NO).

Design: Data were obtained from a nursing database of NO usage and our obstetric anesthesia database. We compared 8 months before and 8 months after the introduction of NO. It was available 24 h/d, 7 d/wk, consistent with neuraxial analgesia availability. Epidural utilization before and after introduction of NO was compared using χ analysis.

Setting: Labor and delivery floor.

Main Results: Total number of births over the study period was 8539: 4315 pre-N2O and 4224 post-NO. The rate of epidural usage was 77% pre-NO and 74% after NO (P= not significant, χ). A total of 762 patients used NO. Monthly analysis showed no change in pattern of neuraxial analgesia use in post-NO period compared with the pre-NO period.

Conclusion: The introduction of NO for labor analgesia was not associated with any change in our rate of labor epidural utilization. Under the conditions of our study, these results suggest that NO does not discourage neuraxial use for labor pain relief.