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Parenting

Laughing Gas to Ease Labor Pains?

2:00

Like many Americans, you may think laughing gas (Nitrous Oxide) is something that is only used in a dentist’s office to ease the fear of dental work.  But if you live outside the U.S., you’re more likely to associate the pain reducing gas with childbirth.

A recent U.S. survey based on interviews with a representative sample of nearly 1,600 women who gave birth in American hospitals in 2005, showed that only about 1% of American women used nitrous oxide for pain relief during labor, as compared to 69 % of British women and 70% of New Zealanders.

However, U.S. doctors say that these figures may already be starting to shift in favor of using laughing gas in the delivery room.

Laughing gas used to be given to women during delivery quite often - but was replaced in the 1930s by the epidural for controlling pain. Today in the delivery room, epidurals are used almost exclusively for medically- induced pain relief.

In 2011, the Food and Drug Administration approved new laughing gas equipment to be used in American delivery rooms, and this resulted in a resurgence of use in America.

"Maybe 10 years ago, less than five or 10 hospitals used it [for women in labor]," Dr. William Camann, director of obstetric anesthetics at Brigham and Women's Hospital, told ABC News. "Now, probably several hundred. It’s really exploded. Many more hospitals are expressing interest."

Why should a woman consider using laughing gas during labor?  There are actually quite a few pros.

Laughing gas is regarded as a less extreme pain relief option during labor, when compared to the traditional epidural. It’s recommended for women who opt for a natural delivery but simply need a bit of help along the way.

"It's a relatively mild pain reliever that causes immediate feelings of relaxation and helps relieve anxiety," Camman explained. "It makes you better able to cope with whatever pain you’re having."

According to an article published in the journal Birth, “Although nitrous oxide provides much less complete pain relief than an epidural, it is enough for many women. It is eliminated through the lungs rather than the liver, and so does not accumulate in the mother’s or baby’s body. Unlike opioids, it does not depress respiration.”  

Another advantage is the cost. Nitrous oxide is a lot less expensive than an epidural. The average cost for a woman choosing laughing gas during labor may be less than a $100, compared to an epidural, which may run as high as $3,000 according to some experts.

One of the biggest complaints for women who undergo an epidural is the numbness they experience far after labor. It can take sometimes hours for women to regain complete sensation in the lower half of their body, but with laughing gas the effects wear off nearly as soon as inhalation ceases.

There are cons associated with laughing gas as well. It doesn’t completely alleviate the pain and many women feel it just isn’t strong enough. It can also cause some disorientation and a change in awareness.

Laughing gas is also known to have side effects such as nausea, dizziness, and drowsiness. Although these are not experienced by all women who use the gas for pain relief, for those that do, it can blemish the birthing experience.

Ultimately, the choice whether or not to use laughing gas is completely up to the mom’s comfort level. She can also opt to have an epidural if she finds she does not like the effects of the gas or feels that it is not providing enough relief from the pain. Unfortunately, at this point many hospitals in America do not even offer laughing gas as an option, but perhaps due to this recent surge in popularity more delivery rooms will become stocked with the pain relief option in time. 

Having gone through the birthing experience myself, I vote for as many safe pain-relieving options as possible!

Sources: Dana Dovey, http://www.medicaldaily.com/laughing-gas-pain-relief-when-giving-birth-becoming-popular-option-among-new-moms-319180

Judith P. Rooks, CNM, MPH, MS http://onlinelibrary.wiley.com/doi/10.1111/j.1523-536X.2006.00150.x/full

Your Child

FDA Warning: Don’t Give Kids Codeine, Tramadol

1:45

The U.S. Food and Drug Administration (FDA) recently issued a warning about the dangers of two popular painkillers and the effects they can have on children. The government agency said that Codeine and Tramadol should not be given to kids under the age of 12 because they can cause life-threatening breathing problems.

Nursing mothers should also avoid using these drugs, since they can pass unsafe levels of opioids to their babies through their breast milk, the agency said.

Some children and adults are genetically predisposed to process opioid drugs more quickly, the FDA said. That can cause the level of narcotics in the bloodstream to rise too high and too quickly, risking overdose in children, due to their smaller size.

"It's very hard to determine which child or mother has this risk, so that's why we've taken this action today," Dr. Douglas Throckmorton, deputy center director for regulatory programs at the FDA's Center for Drug Evaluation and Research, said in a media briefing.

Codeine is often combined with acetaminophen in prescription pain medicines and cough syrups, while Tramadol is only approved to treat pain in adults, the agency said.

The FDA is now warning against children under 12 years old taking either codeine or tramadol.

Kids under 18 also should not be given tramadol to treat pain following surgery to remove the tonsils or adenoids, the agency noted. Codeine labeling already warns against post-surgical use for kids.

In particular, children with sleep apnea, are obese or who have a weakened respiratory system are at a higher risk for dangerous breathing problems from these two drugs.

"Today's actions build on a better understanding of this very serious safety issue, based on the latest evidence," Throckmorton said.

Both of these medications are often prescribed and are in households.  Nearly 1.9 million kids aged 18 or younger received a prescription for a codeine-containing medication in 2014, and nearly 167,000 were prescribed a medication containing tramadol, the FDA said.

Parents should carefully read drug labels to make sure medications don't contain either opioid, the agency stressed. They also can ask their doctor or pharmacist if a specific medication contains codeine or tramadol.

"We understand there are limited options when it comes to treating pain and cough in children," Throckmorton said. "However, after careful review our decision to require these labeling updates was taken because we believe it is a way we can protect children."

The FDA plans to hold a public advisory committee meeting later this year to discuss the broader use of prescription opioid cough and cold medicine in children, he said.

Story source: Dennis Thompson, http://www.webmd.com/children/news/20170420/dont-give-kids-medicines-with-codeine-tramadol-fda#1

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