Pregnant women have started using opioids instead of nitrous oxide (laughing gas) to relieve labour pain during the Coronavirus pandemic, reported an Australian study. According to Clinicians at Lyell McEwin Hospital, Adelaide, Australia, opioid use did not report any adverse effects on the child or mother. They checked the effects of withdrawing nitrous gas and found no significant change in labour duration and nitrous oxide epidural use, a method of drug administration in the spine. However, they observed a hike in opioid use. During the pandemic, many hospitals have adopted opioids as a solution for labour pain instead of nitrous oxide.
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How much pain is experienced during labour pain?
Labour pain is caused by the contractions of uterus muscles which puts pressure on the cervix (birth canal). This pain can be experienced as strong crampings in the groin, abdomen and back. Pain during labour varies from woman to woman and pregnancy to pregnancy. According to the American Society of Anesthesiologists, 45 percent of women describe labour pain as pain felt during menstrual cramps, 16 percent describe it as unbearable back pain, and 15 percent refer to it as broken bone pain.
Why is laughing gas administered during labour pain, and what are its effects?
Small doses of nitrous oxide are used to keep women relaxed during labour pain. The gas is considered an analgesic or pain relief and is administered into the woman’s respiratory system using a mask on her mouth. The gas relieves pain by slightly numbing body parts, which means that the woman might feel low-intensity pain. However, its high doses can lead to complete loss of sensation. Laughing gas can help women by both lessening anxiety and easing pain. Experts did not report its harmful effects on the health of the mother and baby when given on a short-term basis. However, more research is required to discover its long-term impacts.
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Can opioids be an alternative to laughing gas for labour pain relief?
Researchers at the University of Adelaide and South Australia surveyed 243 birthing women at Lyell McEwin Hospital to know which treatment option for labour pain is popular among them. Over the past few years, healthcare providers have reduced nitrous oxide use to minimise the chances of virus transmission from aerosol-generating procedures. These procedures involve droplet production from coughing, sneezing, laughing and talking, which increase the risk of catching infectious respiratory diseases. Hence, medications triggering droplet production, such as nitrous oxide, are usually avoided as a treatment option for labour pain. However, some hospitals do offer nitrous oxide for pain relief to date.
As the gas can cause contagious respiratory problems, especially during Covid, most women preferred opioids as a labour pain reliever during the survey. As per the Australian Institute of Health and Welfare, 50 percent of women in Australia use nitrous oxide (inhaled) during labour pain, followed by opioids and epidurals. Its high carbon footprint has raised questions about whether it should be replaced with other pain relief options like opioids. Hospitals can provide both options: nitrous oxide and opioids, and let the woman choose the best pain relief medication for herself.
The study results were published in journal Australian and New Zealand Journal of Obstetrics and Gynaecology.