Pinyan Toni, Curlee Kelly, Keever Mellanie, Baldwin Kathleen M
Toni Pinyan is a Charge Nurse at Women/Infants Services, Texas Health Harris Methodist Hospital Cleburne, Cleburne, TX. Kelly Curlee is Director at Women/Infants Services, Texas Health Harris Methodist Hospital Cleburne, Cleburne, TX. Mellanie Keever is Supervisor at Women/Infants Services, Texas Health Harris Methodist Hospital Cleburne, Cleburne, TX. Kathleen M. Baldwin is Nurse Scientist at Texas Health Resources, Arlington, TX. The author can be reached via e-mail at
MCN Am J Matern Child Nurs. 2017 May/Jun;42(3):160-165. doi: 10.1097/NMC.0000000000000336.
Nitrous oxide has a long history of use and has been well documented in the literature as a safe, effective, and inexpensive option for pain management in labor in other countries, but it is underused in the United States.
Pain relief options for laboring women in rural community hospitals with a small perinatal service are limited due to lack of availability of in-house anesthesia coverage.
This quality improvement project involved development and implementation of a nurse-driven, self-administered, demand-flow nitrous oxide program as an option for pain relief for laboring women in a rural community hospital.
Women's Services registered nurses developed the project using an interdisciplinary team approach based on an extensive literature review and consultation with experts across the country. The hospital is part of a large healthcare system; approval was sought and obtained by the system as part of the project. Cost analysis and patient satisfaction data were evaluated. Outcomes were monitored.
Approximately one half of the patients who have given birth at the hospital since initiation of the project have used nitrous oxide during labor. The majority of women who participated in a survey after birth found it helpful during mild-to-moderate labor pain. No adverse effects have noted in either the mother or the baby following nitrous oxide use.
Initiation and management of nitrous oxide by registered nurses is a safe and cost-effective option for labor pain. It may be especially beneficial in hospitals that do not have 24/7 in-house anesthesia coverage.
一氧化二氮有很长的使用历史，在其他国家的文献中已有充分记载，是分娩疼痛管理中一种安全、有效且廉价的选择，但在美国其使用不足。
由于缺乏内部麻醉服务，围产期服务规模较小的农村社区医院中，分娩妇女的疼痛缓解选择有限。
这个质量改进项目涉及开发并实施一项由护士主导、患者自行给药、按需供应的一氧化二氮项目，作为农村社区医院分娩妇女疼痛缓解的一种选择。
妇女服务部门的注册护士基于广泛的文献综述并与全国各地的专家协商，采用跨学科团队方法开展了该项目。该医院是一个大型医疗系统的一部分；作为项目的一部分，已获得该系统的批准。对成本分析和患者满意度数据进行了评估。对结果进行了监测。
自项目启动以来，在该医院分娩的患者中约有一半在分娩时使用了一氧化二氮。大多数产后参与调查的妇女发现它对缓解轻度至中度分娩疼痛有帮助。使用一氧化二氮后，母亲和婴儿均未出现不良反应。
注册护士启动和管理一氧化二氮用于分娩疼痛是一种安全且具有成本效益的选择。在没有全天候内部麻醉服务的医院中可能特别有益。
