Introduction of Inhaled Nitrous Oxide and Oxygen for Pain Management during Labour - Evaluation of Patients' and Midwives' Satisfaction.

Abstract:

:Aim: Effective pain management during labour is important because pain affects the birth experience. Epidural analgesia is effective but often it may not be possible; however, inhaled analgesia offers another option. Use of inhaled nitrous oxide and oxygen for pain management in labour is well established in obstetrics but is still not used much in Germany. This study aimed to investigate the acceptance of the inhaled analgesia of inhaled nitrous oxide and oxygen by midwives and pregnant women during labour. Material and Methods: In this observational study carried out between April and September 2013, a total of 66 pregnant women received inhaled nitrous oxide and oxygen during labour on request and after prior assessment of suitability. After the birth, all of the women and the responsible midwives were interviewed about their experience and satisfaction with the inhaled analgesia. Results: A statistically significant reduction of pain was achieved with nitrous oxide and oxygen. The inhaled analgesia was mostly used by women who refused epidural analgesia. The likelihood of using inhaled nitrous oxide and oxygen again was reported as higher for patients who tolerated it well (p = 0.0129) and used it in the second stage of labour (p = 0.0003) and when bearing down (p = 0.0008). Conclusion: Inhaled nitrous oxide and oxygen is an effective method for pain management during labour and is accepted well by women in labour and by midwives. ZUSAMMENFASSUNG:Ziel: Das Schmerzempfinden beeinflusst das Geburtserlebnis, weshalb die Schmerztherapie unter Geburt wichtig ist. Zwar kann die effektive Periduralanästhesie nicht immer angewendet werden, jedoch gibt es mit Lachgas-Sauerstoff-Gemischen eine weitere Alternative. Lachgasgemische sind etablierte Verfahren, finden jedoch in Deutschland noch keine breite Anwendung. Ziel dieser Arbeit ist zu prüfen, wie die Anwendung des Lachgasgemischs unter Geburt von Schwangeren und Hebammen angenommen wird. Material und Methode: In dieser Beobachtungsstudie erhielten zwischen April und September 2013 insgesamt 66 Schwangere unter Geburt bei vorliegender Indikation und Wunsch das Lachgas-Sauerstoff-Gemisch. Alle Frauen wurden nach Geburt zu ihrer Erfahrung und Zufriedenheit mit dem Lachgasgemisch befragt. Zusätzlich dokumentierten die betreuenden Hebammen ihre Zufriedenheit mit der Wirkung des Lachgasgemischs in der entsprechenden Situation. Ergebnis: Unter dem Lachgas-Sauerstoff-Gemisch konnte eine statistisch signifikante Schmerzreduktion erzielt werden. Dabei wurde das Lachgasgemisch am häufigsten bei Frauen verwendet, die eine PDA verweigerten. Die Wahrscheinlichkeit, das Lachgas-Sauerstoff-Gemisch wieder zu verwenden, war höher, wenn es von den Patientinnen besser vertragen (p = 0,0129) und in der Austreibungsperiode (p = 0,0003) und Pressphase (p = 0,0008) angewendet wurde. Schlussfolgerung: Das Lachgas-Sauerstoff-Gemisch ist eine effektive Methode zur Schmerzlinderung unter Geburt, die sowohl von den Gebärenden als auch von den betreuenden Hebammen gut angenommen wird.

authors

Dammer U,Weiss C,Raabe E,Heimrich J,Koch MC,Winkler M,Faschingbauer F,Beckmann MW,Kehl S

doi

10.1055/s-0034-1368606

subject

Has Abstract

pub_date

2014-07-01 00:00:00

pages

656-660

issue

7

eissn

0016-5751

issn

1438-8804

journal_volume

74

pub_type

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