Background: Although nitrous oxide (N2O) 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 N2O, but as of 2020, several hundred labor units have adopted its use. Methods: We reviewed the literature and summarize the mechanism of action, clinical uses, and efficacy of N2O for labor analgesia, as well as patient satisfaction related to its use. Results: N2O has several proposed mechanisms of action that make it a viable option for all 3 stages of labor and postpartum procedures. N2O has been shown to be a safe option for both mom and baby during labor and delivery. Studies support N2O as an analgesic for laboring. Even though 40% to 60% of women who use N2O convert to a labor epidural analgesia, satisfaction surveys indicate that analgesia is not the only factor contributing to the use of N2O during labor. Conclusion: The use of N2O has increased in labor and delivery units across the United States since 2011. Despite inferior analgesic properties compared to epidural analgesia, N2O offers a safe alternative for many parturients who want a greater sense of control and mobility.
Keywords: Analgesics; labor pain; labor–obstetric; nitrous oxide.
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