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用于分娩镇痛的氧化亚氮:我们目前所了解的情况。

Nitrous Oxide for Labor Analgesia: What We Know to Date.

作者信息

Broughton Kirbie, Clark Allison G, Ray Adrienne P

机构信息

Department of Anesthesiology, Ochsner Clinic Foundation, New Orleans, LA.

The University of Queensland Faculty of Medicine, Ochsner Clinical School, New Orleans, LA.

出版信息

Ochsner J. 2020 Winter;20(4):419-421. doi: 10.31486/toj.19.0102.

Abstract

Although nitrous oxide (NO) has been used since the 1880s for labor analgesia, its popularity has only recently increased in the United States. In 2011, only 3 centers in the country offered NO, but as of 2020, several hundred labor units have adopted its use. We reviewed the literature and summarize the mechanism of action, clinical uses, and efficacy of NO for labor analgesia, as well as patient satisfaction related to its use. NO has several proposed mechanisms of action that make it a viable option for all 3 stages of labor and postpartum procedures. NO has been shown to be a safe option for both mom and baby during labor and delivery. Studies support NO as an analgesic for laboring. Even though 40% to 60% of women who use NO convert to a labor epidural analgesia, satisfaction surveys indicate that analgesia is not the only factor contributing to the use of NO during labor. The use of NO has increased in labor and delivery units across the United States since 2011. Despite inferior analgesic properties compared to epidural analgesia, NO offers a safe alternative for many parturients who want a greater sense of control and mobility.

摘要

尽管自19世纪80年代以来一氧化二氮(NO)就已用于分娩镇痛,但直到最近它在美国才开始流行起来。2011年,美国仅有3家机构提供一氧化二氮,但截至2020年,已有数百个分娩单元采用了这种方法。我们查阅了相关文献,总结了一氧化二氮用于分娩镇痛的作用机制、临床应用、疗效以及患者对其使用的满意度。一氧化二氮有多种作用机制,使其成为分娩三个阶段及产后程序的可行选择。研究表明,在分娩和分娩过程中,一氧化二氮对母婴来说都是一种安全的选择。多项研究支持将一氧化二氮用作分娩镇痛剂。尽管使用一氧化二氮的女性中有40%至60%最终会转为硬膜外分娩镇痛,但满意度调查显示,镇痛并非分娩期间使用一氧化二氮的唯一因素。自2011年以来,美国各分娩单元对一氧化二氮的使用有所增加。尽管与硬膜外镇痛相比,一氧化二氮的镇痛效果较差,但对于许多希望获得更强控制感和活动能力的产妇来说,它提供了一种安全的替代选择。

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