Nitrous oxide for analgesia in external cephalic version at term: prospective comparative studya

Jorge Burgos; Patricia Cobos; Carmen Osuna; María de Mar Centeno; Luis Fernández-Llebrez; Txanton Martinez Astorquiza; Juan Carlos Melchor

doi:10.1515/jpm-2013-0046

Article

Nitrous oxide for analgesia in external cephalic version at term: prospective comparative study^a

Jorge Burgos , Patricia Cobos , Carmen Osuna , María de Mar Centeno , Luis Fernández-Llebrez , Txanton Martinez Astorquiza and Juan Carlos Melchor

Published/Copyright: August 8, 2013

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From the journal Journal of Perinatal Medicine Volume 41 Issue 6

Abstract

Objective: The objective of this study was to analyze the effect of using inhaled nitrous oxide (N₂O) for analgesia in external cephalic version (ECV) at term on the success rate of the procedure, on pain, and on obstetric and perinatal outcomes.

Methods: A prospective comparative cohort study among 300 women with singleton pregnancy in breech presentation at term undergoing an ECV with inhaled N₂O in a 50:50 mix with oxygen for analgesia and 150 ECVs with no analgesia.

Results: The success rate was 52.3% in the N₂O cohort and 52.7% in the controls (P=0.94), whereas the median level of pain was statistically lower in women given N₂O (median, 6; range, 4–7, vs. median, 7; range, 5–8; P<0.01). This improvement is mainly from a 49% decrease in severe pain. There were no significant differences in the rate of complications associated with the ECV, in the rate of cesarean sections, or in perinatal outcomes. Furthermore, there were no severe complications secondary to N₂O inhalation.

Conclusions: N₂O inhalation at a concentration of 50% for analgesia during ECV decreases the level of severe pain experienced by women, appears to be safe both for mother and child, and has no influence on the success rate of ECV or the perinatal outcomes.

Keywords: Anesthesia; breech presentation; nitrous oxide; obstetrics; pregnancy complications; version fetal

Corresponding author: Jorge Burgos, Obstetrics and Gynecology Service, Cruces University Hospital C/Plaza de Cruces 12, 48903, Baracaldo, Biscay, Spain, Tel.: +34-946006000, E-mail: jburgoss@sego.es

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Ethics approval: Clinical Research Ethics Committee approval was granted for the study (EC09/29), and in all the cases, the procedure was performed after informed consent had been obtained from the women.

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The authors stated that there are no conflicts of interest regarding the publication of this article.

Received: 2013-3-4

Accepted: 2013-7-8

Published Online: 2013-08-08

Published in Print: 2013-11-01

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Articles in the same Issue

https://doi.org/10.1515/jpm-2013-0046

Keywords for this article

Anesthesia; breech presentation; nitrous oxide; obstetrics; pregnancy complications; version fetal