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Impact of nitrous oxide use on parturient recall of neuraxial analgesia risks.
Sharpe, Emily E; Warner, Lindsay L; Brakke, Benjamin D; Davis, Paul R; Finkel, David M; Burkle, Christopher M; Hanson, Andrew C; Pompeian, Rochelle J; Arendt, Katherine W; Butler Tobah, Yvonne S; Sviggum, Hans P.
Afiliación
  • Sharpe EE; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic School of Graduate Medical Education, Mayo Clinic College of Medicine and Science, Rochester, MN, United States of America. Electronic address: sharpe.emily@mayo.edu.
  • Warner LL; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic School of Graduate Medical Education, Mayo Clinic College of Medicine and Science, Rochester, MN, United States of America.
  • Brakke BD; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic School of Graduate Medical Education, Mayo Clinic College of Medicine and Science, Rochester, MN, United States of America.
  • Davis PR; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic School of Graduate Medical Education, Mayo Clinic College of Medicine and Science, Rochester, MN, United States of America.
  • Finkel DM; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic School of Graduate Medical Education, Mayo Clinic College of Medicine and Science, Rochester, MN, United States of America.
  • Burkle CM; Emeritus Member, Mayo Clinic School of Graduate Medical Education, Mayo Clinic College of Medicine and Science, Rochester, MN, United States of America.
  • Hanson AC; Department of Anesthesiology and Perioperative Medicine, Division of Clinical Trials and Biostatistics, Mayo Clinic School of Graduate Medical Education, Mayo Clinic College of Medicine and Science, Rochester, MN, United States of America.
  • Pompeian RJ; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic School of Graduate Medical Education, Mayo Clinic College of Medicine and Science, Rochester, MN, United States of America.
  • Arendt KW; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic School of Graduate Medical Education, Mayo Clinic College of Medicine and Science, Rochester, MN, United States of America.
  • Butler Tobah YS; Department of Obstetrics and Gynecology, Mayo Clinic School of Graduate Medical Education, Mayo Clinic College of Medicine and Science, Rochester, MN, United States of America.
  • Sviggum HP; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic School of Graduate Medical Education, Mayo Clinic College of Medicine and Science, Rochester, MN, United States of America.
J Clin Anesth ; 98: 111579, 2024 Nov.
Article en En | MEDLINE | ID: mdl-39128257
ABSTRACT
STUDY

OBJECTIVE:

Nitrous oxide affects memory and recall. We aimed to determine if using nitrous oxide during labor affected patients' ability to learn and recall the risks and benefits of neuraxial analgesia.

DESIGN:

Single-center, prospective cohort study.

SETTING:

Labor and delivery unit in a large academic medical center. PATIENTS Nulliparous patients with spontaneous or planned induction of labor.

INTERVENTIONS:

Parturients chose whether to use nitrous oxide during labor. At the discussion for epidural consent, 4 risks were described headache, infection, nerve damage, bleeding. MEASUREMENTS Labor pain score, time from nitrous oxide discontinuation, and cervical dilation were documented at the discussion of epidural risks. Patients were assessed for unprompted recall and prompted recall of epidural risks on postpartum day 1 and unprompted recall at postpartum week 6. The number and proportion of patients who indicated each true risk (unprompted and prompted recall) or distractor (prompted recall only) were summarized by treatment group and results compared using Pearson χ2 tests. MAIN

RESULTS:

Of the 403 enrolled patients, 294 (73%) did not use nitrous oxide, and 109 (27%) did. The 2 groups were similar except women who used nitrous oxide were more likely to be cared for by midwives and had higher pain scores at their epidural request. Scores for unprompted or prompted recall of epidural risks were not different between women who received or did not receive nitrous oxide. All 4 risks were recalled unprompted by only 3% in the nitrous oxide group and by 6% in the group not receiving nitrous oxide (P = .18).

CONCLUSIONS:

The use of nitrous oxide for labor analgesia does not adversely influence a parturient's ability to recall the risks of epidural placement. Patients who receive nitrous oxide for labor analgesia should be considered eligible to provide consent for subsequent procedures.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Recuerdo Mental / Analgesia Epidural / Analgesia Obstétrica / Óxido Nitroso Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: J Clin Anesth Asunto de la revista: ANESTESIOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Recuerdo Mental / Analgesia Epidural / Analgesia Obstétrica / Óxido Nitroso Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: J Clin Anesth Asunto de la revista: ANESTESIOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos