Effect of Entonox for pain management in labor: A systematic review and meta-analysis of randomized controlled trials

Sheyklo, Sepideh Gareh; Hajebrahimi, Sakineh; Moosavi, Ahmad; Azar, Fatemeh Pournaghi; Azami-Aghdash, Saber; Ghojazadeh, Morteza

doi:10.19082/6002

Cited by 12 publications

(5 citation statements)

References 28 publications

(18 reference statements)

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“…12 A meta-analysis by Sheyklo et al showed that the satisfaction rate of the mothers in the Entonox group was 57.6% as compared to 21.3% of mothers in the oxygen group showing a high level of satisfaction. 13 The duration of the active phase of labor in the Entonox group was comparable to the oxygen group in our study. Results of a study by Attar et al revealed that patients in the Entonox group experienced less pain (p ≤ 0.001) as compared to the oxygen group and also had less duration of delivery (p ≤ 0.001).…”

Section: Discussionsupporting

confidence: 70%

A Randomized Controlled Trial of Entonox and Oxygen in Labor Analgesia

Mukhopadhyay¹,

Raj²,

Aggarwal³

2021

Journal of South Asian Federation of Obstetrics and Gynaecology

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Background and objectives: Labor pain is a severe form of pain experienced by a woman, leading to tremendous stress. Several routes for labor analgesia have been tried. Entonox is a premixed homogeneous gas mixture of nitrous oxide and oxygen in the ratio of 50:50 providing conscious sedation in obstetrics during labor. It is a safe and effective analgesia for obstetrics use due to its properties of rapid onset, short half-life, and rapidly disappearing symptoms on withdrawal of the gas. Therefore, we aimed to evaluate the effect of Entonox on the severity and relief of labor pain during its various stages and its associated maternal or fetal side effects. Materials and Methods: A prospective randomized controlled trial (RCT) of 200 term pregnant mothers reporting in labor over a period of 2 months who were randomized into Entonox group and placebo oxygen control group was included in the study. Administration of both gases was done, and the pain scoring was recorded. Maternal and fetal complications were noted. Results: The intensity of labor pain was significantly lower in Entonox group as evident by lower pain scoring values. The mean duration of the active phase of labor in the Entonox group was comparable to the oxygen group. Maternal and fetal side effects were not significant in both groups. The mode of delivery is also comparable in both groups. Conclusion: Entonox usage in labor analgesia is a safe, effective, and inexpensive method of relieving labor pain, achieving immense patient satisfaction and making labor a pleasurable experience.

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Section: Discussionsupporting

confidence: 70%

A Randomized Controlled Trial of Entonox and Oxygen in Labor Analgesia

Mukhopadhyay¹,

Raj²,

Aggarwal³

2021

Journal of South Asian Federation of Obstetrics and Gynaecology

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“…Systematic review and meta-analysis on nitrous oxide for the management of labor pain reported that only few studies of good or fair quality have been published, and the control groups were very heterogeneous [ 2 ]. The review concluded that further research is needed across all of the areas examined: effectiveness, satisfaction, and adverse effects [ 2 , 3 ]. Accordingly, we conducted this study aimed mainly to compare visual analog scores of labor pain and satisfaction levels between women who received nitrous oxide (Entonox ® ) and those who received meperidine, and also to compare the neonatal outcomes, labor courses, and cesarean section rate between both groups.…”

Section: Introductionmentioning

confidence: 99%

Entonox® versus Pethidine in Labor Pain Relief: A Randomized Controlled Trial

Chantrasiri

Wanapirak

Tongsong

2021

IJERPH

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Background: Pain relief during labor is a part of standard care in modern obstetrics. Several modalities used for pain relief have their own disadvantages and benefits in terms of side effects, effectiveness, availability, and satisfaction. The objectives of this study are primarily to compare the effectiveness and patients’ satisfaction for pain relief during labor between pethidine and inhaled 50% nitrous oxide (Entonox®). Methods: Laboring women at 37–41 + 6 weeks of gestation were randomly allocated to receive pethidine (50 mg intravenously) or Entonox® for reducing labor pain. Pain scores were evaluated at 0, (baseline), 30, 60, 90, and 120 min after initiation, using the visual analog scale (VAS) and also satisfaction score after delivery using the verbal rating scale (VRS). The secondary outcomes were also assessed, including APGAR scores, labor course, side effects, and cesarean section rate. Results: A total of 136 laboring women underwent randomization into two groups, but only 58 and 65 in the pethidine group and the Entonox® group were available for analysis. The median pain scores at baseline, 30, 60, and 90 min were comparable between both groups (p-value > 0.05); however, pain score at 120 min in the pethidine group was significantly higher (p-value: 0.038). The median of satisfaction score was significantly higher in the Entonox® group (4 vs. 3; p-value 0.043). All of the secondary outcomes were comparable between the two groups. Conclusions: Both have comparable effectiveness, but Entonox® has a higher satisfaction score. Entonox® could be an alternative to pethidine for reducing labor pain, because of its efficacy, ease for self-adjustment for satisfaction, and no serious effects on the labor course and newborns.

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“…It can reduce the use of pethidine during labor pain without significant increase in maternal and neonatal complications. [12][13][14][15] Another study found that colonoscopy patients using Entonox felt no more discomfort than those sedated intravenously. Entonox was not associated with a reduction in colonoscopy quality, and patients who received Entonox recovered more rapidly than patients who received intravenous sedation.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of inhalation of a nitrous oxide and oxygen mixture for pain management during rigid cystoscopy: a randomized controlled trial

Lohityothin,

Swatesutipan

2023

Insight Urol

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Objective: To evaluate the efficacy of pain management using inhalation of a nitrous oxide and oxygen mixture during rigid cystoscopy. Materials and Methods: A total of 55 patients were prospectively selected and randomized to receive oxygen (27) or Entonox (28). Both groups were given the respective gas for 3 minutes via breath-activated facemask before cystoscopy and continued to breathe the gas until the end of the procedure. The oxygen and Entonox groups received 20 ml 2% lidocaine gel intraurethral 15 minutes before the procedure. Heart rate, and numeric pain rating scales were recorded before, during, and after the cystoscopy. Results: Fifty-five patients were randomized into two groups, 27 were given oxygen and 28 Entonox. There were no statistically significant differences between the groups in terms of baseline patient characteristics. Intraoperative rigid cystoscopy pain scores were significantly lower in the Entonox group than in the oxygen group (2.4 vs 4.2, p = 0.009). There were no significant differences between the two groups as regards postoperative pain, intraoperative and post-operative heart rates, and side effects. Conclusion: Entonox significantly reduces intraoperative cystoscopy-related pain, without significant complications.

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Effect of Entonox for pain management in labor: A systematic review and meta-analysis of randomized controlled trials

Cited by 12 publications

References 28 publications

A Randomized Controlled Trial of Entonox and Oxygen in Labor Analgesia

A Randomized Controlled Trial of Entonox and Oxygen in Labor Analgesia

Entonox® versus Pethidine in Labor Pain Relief: A Randomized Controlled Trial

Efficacy of inhalation of a nitrous oxide and oxygen mixture for pain management during rigid cystoscopy: a randomized controlled trial

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