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Re: N2O in laborFrom: Jason Gardosi (jason.gardosi@nottingham.ac.uk)Fri Dec 29 06:48:45 1995
>Shnider (2nd ed, 1987) Anesthesia for Obstetrics associated aspiration with inhalational agents in general, and also points out that there can be a significant fall in uterine blood flow in pregnant ewes experimentally given inhalational nitrous oxide. Josh - I agree there seems to be a dearth of publications. Cohen's review in the textbook you quote is still the one usually referred to. I have never seen any problems with N2O - self-administration prevents overdosing as mom just lets the mask or mouthpiece drop if she is becoming drowsy. I am not sure whether the reduction in blood flow is significant in humans. There are no changes in the FHR suggesting hypoxia - perhaps because the nitrous is mixed with 50% oxygen. In fact, with a fetal pulse oximeter sensor in place and an iffy FHR trace, I have seen two cases where the oxygen saturation increased when the mother started N2O (and returned to previous baseline after she stopped). Usually it is unchanged - I have never seen it drop. Jason jason.gardosi@nottingham.ac.uk OB/GYN, Queen's Medical Centre University of Nottingham, UK
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