Using Nitrous Oxide “Cracking” Technology in the Delivery Room

In a case report published in anesthesia reportA 35-year-old woman, herself an anesthesiologist, describes her own use of a special device to restore and break down nitrous oxide, which is used to relieve pain during labour, and in most cases , stated that the equipment was easy to use. She also talks about her positive feelings about reducing harm to her environment.

Nitrous oxide is a greenhouse gas with a global warming potential of approximately 265 times the equivalent mass of carbon dioxide. Nitrous oxide is the most common analgesic used during labour, so interventions that reduce its release could significantly reduce its environmental impact.

Dr Fiona Martin, consultant anesthesiologist at Salford Royal Hospital, Salford, England, during labor before giving birth to a healthy girl at St Mary’s Hospital, Wythenshaw, part of the University of Manchester NHS Foundation Trust. A nitrous oxide decomposer was used. October 2021. Her device collected (“cleaned”) the nitrous oxide she exhaled from her face mask and broke it down, preventing it from being released into the atmosphere.

Dr. Martin said: Using a cracker may help reduce greenhouse gas emissions associated with the use of nitrous oxide in labor.”

During labor, she uses the birthing pool, and the most difficult moment to keep the facemask tight (and thereby maximize the amount of nitrous oxide expelled) is when she exits the pool during labor. I pointed out that it was time to reposition myself. It was more difficult, but lying on her hands and knees in the typical “prone” position during labor made it easier as the weight of her head pushing down on the mask made the seal better. She adds:

The case report notes that ambient nitrous oxide levels, while low, were detectable throughout labor despite the professionally trained Dr. Martin’s expertise in the use of face masks. . The authors concluded, “Increased nitrous oxide levels appeared to be associated with events that were either uncomfortable or presented challenges in maintaining an effective facemask seal, such as during testing. This suggests that the impact of cracking techniques does not depend solely on efficacy. It may include feedback and support, or consideration of whether the facemask is the most appropriate device for every patient in every situation.”

The authors conclude that: It mitigates the negative environmental and occupational health impacts of nitrous oxide, but as this report shows, it does not fully mitigate them. It may be part of the solution, but it is not the full solution. To move closer to “net zero” health care, nitrous oxide supplies and clinical use must continue. ”

Provided by AAGBI