The following blog was posted on the Our Bodies Ourselves Blog and we felt it may be of interest to some of our followers.
Posted: 11 Nov 2010 08:28 AM PST
Many of you may already be familiar with the systematic and comparative effectiveness reviews produced by the Agency for Healthcare Research and Quality (AHRQ), such as these reviews of the available evidence for birth-related interventions such as labor induction, maternal request c-section, VBAC, and episiotomy.

Recently, AHRQ has become more active in soliciting public input to the review process, and today they posted for public comment the key questions and background materials for a review that will be conducted soon, Comparative Effectiveness of Nitrous Oxide for the Management of Labor Pain.

Nitrous oxide is commonly available to women for labor pain relief in many other countries, but is almost completely unavailable as an option for women in the United States. The comparative effectiveness review on this topic will examine the available evidence and look at specific questions such as its effectiveness, adverse effects, effects on women’s satisfaction with their birth experience and pain management, and health system factors influencing whether nitrous oxide is available to women who would like that option.

The public is invited to comment on this list of key questions to be addressed by the review, and can also review some background information describing the current use of nitrous oxide in the United States, the nature of the available literature, and the outcomes the review will examine.
Public comment is being accepted through December 8, 2010 via this online form; the site also provides a document to download and submit by mail if you prefer.

This project is of particular interest to me because of my work with the AHRQ Evidence-based Practice Center conducting this review. I have been involved with this topic in its preliminary stages by helping to examine the literature and writing up background information to inform the feasibility and potential impact of a full comparative effectiveness review. I will continue to be involved with the project team when the full review begins, and of course will update here when the review is completed and released.

For additional discussion of nitrous oxide for labor pain relief, please see our 2008 post with guest commentary from Judith Rooks, who has been advocating for expanded access to this choice for U.S. women.

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Comments

It will no doubt come as a shock to many well meaning anesthesiologists and nurses who do not have access to current information on this topic. It is painful to realize that US medical schools do not teach accurate information and to worry that information is being withheld or altered in order to promote the staus quo or to fulfill profit motives.

An excerpt from a Pubmed systematic review conducted to determine the efficacy and safety of nitrous oxide for labor analgesia. "Nitrous oxide is not a potent labor analgesic, but it is safe for parturient women, their newborns, and health care workers in attendance during its administration. It appears to provide adequately effective analgesia for many women".

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