IS LAUGHING GAS A GOOD ALTERNATIVE TO EPIDURAL?

To date, with some exceptions, a woman who goes to the hospital to give birth has two possible choices: do it with epidural or do it without epidural. Epidural anesthesia carries some associated risks, prevents the woman from putting herself in the position that best suits her and encourages births to lengthen. The alternative, not to use it, makes childbirth safer, but requires mentalization, of professionals who help and respect labor and that it hurts more, and that is why many women end up asking for it.

In the search to allow women to have freedom of movement and allow labor to progress with the least interference, some countries make use of nitrous oxide or laughing gas, a gas that is inhaled through a mask and whose effect diminishes and disappears when it is removed. The doubt is: Is laughing gas a good alternative to epidural?

Widely used in many countries

Nitrous gas is a colorless and odorless gas that is used in up to 50% of deliveries in Finland, Canada, Australia and 60% of those in the United Kingdom, because it is economical, easy to use and relatively useful. Precisely for this reason it is strange that its use does not extend in Spain or in countries like the USA, where very few hospitals offer it.

It is a gas that was discovered in 1771 and began to be used in 1934, when a device that allowed self-administration was created, and is currently offered mixed with oxygen in a concentration of 50%, in order to mitigate the toxic and hallucinogenic effects of nitrogen at higher concentrations.

What is the effect of laughing gas?

The effect of laughing gas is that of neutralize nerve transmission at the brain level. Something like limiting the transmission of the sensation of pain to the brain, helping it hurt a little less, or the pain is lived differently.

When a person breathes it he feels a kind of dizziness and pleasant relaxation that can lead to laughter at times when there is no pain.

When there is pain, the woman notices and says: "It hurts." The difference with not using it is that you can add a "But nothing happens, I don't care".

Is it an alternative to the epidural?

The gas of laughter is administered through a mask and it is the mother herself who is putting it on and taking it off. The effect is very fast (starts at 30 seconds or so) and also disappears quickly when the mask is removed. The idea is to go using it during contractions and stop breathing it in the time between them.

The use of laughing gas allows freedom of movement, allows birth control, avoids a lot of interventions and recovery is instantaneous. In comparison, epidural anesthesia causes you to lose the sensation of thrusting and can cause the use of many measures (the use of oxytocin, lithotomy position, etc.) that instrumentalize and make labor longer, at the risk of ending in Caesarean section or with other complications.

Now, the difference is not just that. The difference is that with the epidural a birth does not hurt, but with nitrous oxide it does. It is true that it hurts differently, that the woman loses a little fear of pain, that she can endure it, but it also hurts.

If a woman wants to give birth without knowing, or without suffering, the gas of laughter is not a suitable alternative. If a woman, on the other hand, wants to have a natural birth, it is a very practical and useful solution that can help her achieve it.

Let's say it is an intermediate solution for those women who go to the hospital with the intention of having a natural birth without anesthesia and when they are there the pain makes them rethink their choice. The gas of laughter It is an analgesic, not an anesthetic, so the birth continues to hurt, but it will be a solution for many of these women, who may have the desired birth by controlling the contraction pain a bit.

Begins to be used in pediatrics

As a curiosity, I explain that in many hospitals it has been used for some time in pediatrics, basically in the emergency room, where children have some very annoying interventions for them.

The intention is to control the pain so that children suffer as little as possible, so they use the gas of laughter so that they are calmer and then make use of the necessary sedation or anesthesia. That is, the use of gas does not allow them to suture a child without anesthesia, however it does allow professionals to apply anesthesia properly and that the process is not a continuous struggle with the child: it is easier to suture or put a way if the child is relatively calm than if he is jumping on the stretcher.

In a childbirth, being the woman who decides when to breathe, it is she who decides to what extent she wants to feel what the gas offers, but I repeat: it is not comparable to epidural anesthesia, but it is that a birth with epidural is not comparable to a birth without it, at the level of process control, risk and recovery.