• Emily E Sharpe, Lindsay L Warner, Benjamin D Brakke, Paul R Davis, David M Finkel, Christopher M Burkle, Andrew C Hanson, Rochelle J Pompeian, Katherine W Arendt, Yvonne S Butler Tobah, and Hans P Sviggum.
• 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.
• J Clin Anesth. 2024 Nov 1; 98: 111579111579.

Study ObjectiveNitrous 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.DesignSingle-center, prospective cohort study.SettingLabor and delivery unit in a large academic medical center.PatientsNulliparous patients with spontaneous or planned induction of labor.InterventionsParturients chose whether to use nitrous oxide during labor. At the discussion for epidural consent, 4 risks were described: headache, infection, nerve damage, bleeding.MeasurementsLabor 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 ResultsOf 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).ConclusionsThe 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.Copyright © 2024 Elsevier Inc. All rights reserved.

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