Thursday, April 19, 2018
Health

Laughing gas in delivery rooms? More area hospitals say yes

TAMPA — Pregnant with her third child, Lizzy Lester knew she wanted a natural, unmedicated delivery. But she jumped at an option to take the edge off the labor pains: nitrous oxide, or laughing gas.

So the medical staff at Tampa General Hospital wheeled in a bedside device that let Lester breathe the gas through a face mask when she felt she needed it. And did she need it: Baby Sylas Spencer came into the world Tuesday tipping 11 pounds.

"I never felt high. It just made it more tolerable," said Lester, 31, cradling Sylas, whose head was too big for the hospital-issued newborn hat.

Laughing gas doesn't kill pain as an epidural injection does. But, like Lester, many women report that it helps them care less about the pain. Experts say nitrous oxide is cleared from the mother's body through her lungs, so it's also safe for the baby.

Though the gas has been widely used for decades in Europe, Australia and Canada, it didn't catch on in the United States. That's starting to change.

Just in the past few years, midwifery groups have helped spearhead the use of nitrous oxide in an estimated 30 hospitals and birthing centers as an option to help women cope with the pain of childbirth.

Locally, TGH started offering nitrous oxide in delivery rooms this week. Morton Plant Hospital in Clearwater has offered it since June, and Mease Countryside Hospital is scheduled to start doing so Wednesday, a spokeswoman said. St. Joseph's Hospital in Tampa is considering using it as well.

Mary O'Meara, the Tampa midwife who successfully lobbied TGH to offer the gas, saw it used routinely when she worked at a London hospital early in her career. She thinks the timing was right to extend the option to patients here, particularly as new medical devices for self-administering the gas have come on the market.

"The patients are asking for it," said O'Meara, president of Women's Health Care, which is on the TGH campus. "We want to give the mothers options."

Most American women giving birth opt for an epidural, a sometimes-painful spinal injection that offers significant relief but may leave many patients confined to their beds.

O'Meara emphasized that the gas isn't a replacement for an epidural; indeed, some women may request both. But the nitrous oxide can help tide the mother over until she decides if she needs an epidural. And, perhaps most important, the patient administers the nitrous oxide herself.

"The mother feels in control," she said.

Doctors groups have been slow to embrace the use of nitrous oxide, saying there is not enough safety data. The American Congress of Obstetricians and Gynecologists, for instance, has taken no position on it.

But O'Meara said she found that local physicians were open to the use of nitrous oxide once they heard more about it. Some of them have even indicated they want to look into using it for procedures such as inserting an IUD that can cause pain but don't warrant heavy sedation.

At St. Joseph's Children's Hospital, doctors offer nitrous oxide for outpatient procedures like joint injections or spinal taps to decrease anxiety and help children feel relaxed.

Dr. Cathy Lynch, associate vice president for women's health and professor of obstetrics and gynecology at the USF Morsani College of Medicine, said she began hearing more about nitrous oxide as device makers perfected the machines used to deliver the gas.

She said patients may not find the gas particularly helpful over a very long induction. But it's ideal for patients who can't get an epidural for medical reasons or because they are so far along in labor that they can't get the injection.

This week, Lynch had a patient at TGH who came in hoping she would not need an epidural. The labor was slow going until the woman's water broke. Though the pain kicked in, she told Lynch she wanted to stick with the nitrous oxide as long as she could.

"Once she took a couple of breaths, she kind of focused on me and the nurse and followed the instructions of how to push past the pain to get the baby out," said Lynch. The patient never asked for the epidural.

Lester, the new mother of Sylas, said she had nonmedicated deliveries for her first two children, and believed she could do it with Sylas. Her other children — now ages 6 and 8 — each weighed around 3 pounds lighter than their new baby brother. She believes the laughing gas helped make the pain bearable.

"I'm glad we chose it," she said, "because we didn't know he'd be this big."

Contact Jodie Tillman at [email protected] or (813) 226-3374. Follow @JTillmanTimes.

Comments
Florida Hospital Carrollwood spending $17.5 million to expand emergency department

Florida Hospital Carrollwood spending $17.5 million to expand emergency department

Florida Hospital Carrollwood is expanding its emergency department. The hospital, 7171 North Dale Mabry Highway in Tampa, is spending $17.5 million to add 15 new private treatment rooms, new pediatric rooms and waiting areas, and new technology, acco...
Published: 04/18/18
Barbara Bush’s end-of-life decision stirs debate over ‘comfort care’

Barbara Bush’s end-of-life decision stirs debate over ‘comfort care’

As she nears death at age 92, former first lady Barbara Bush’s announcement that she is seeking "comfort care" is shining a light — and stirring debate — on what it means to stop trying to fight terminal illness.Bush, the wife of former President Geo...
Published: 04/17/18
Preparing for the worst, staffers at Johns Hopkins All Children’s learn through simulation

Preparing for the worst, staffers at Johns Hopkins All Children’s learn through simulation

When the patient got violent, Dr. Michelle Hidalgo didn’t have time to think. She had to react. The woman was moving strangely and seemed erratic. Hidalgo had to make a tough call — it was time to physically restrain her for everyone’s safety.Then th...
Published: 04/16/18
Updated: 04/17/18

Lung cancer patients live longer with immune therapy

The odds of survival can greatly improve for people with the most common type of lung cancer if, along with the usual chemotherapy, they are also given a drug that activates the immune system, a major new study has shown.The findings should change me...
Published: 04/16/18
Thousands of pounds of prepackaged salad mixes may have been tainted with E. coli, officials say

Thousands of pounds of prepackaged salad mixes may have been tainted with E. coli, officials say

A Pennsylvania food manufacturer is recalling 8, 757 pounds of ready-to-eat salad products following an E. coli outbreak that has spread to several states and sickened dozens of people.Fresh food Manufacturing Co., based in Freedom, Pennsylvania, is ...
Published: 04/15/18
St. Anthony’s Cancer Center installs bell dedicated to survivors

St. Anthony’s Cancer Center installs bell dedicated to survivors

ST. PETERSBURGSister Mary McNally, vice president of mission at St. Anthony’s Hospital, stood in front of a room of cancer survivors to unveil a silver bell surrounded by butterfly stickers mounted to the wall of the Cancer Center lobby. "So often pe...
Published: 04/13/18
Hand dryers could leave your hands dirtier than you think

Hand dryers could leave your hands dirtier than you think

Washing your hands after you use the bathroom is a good idea. But using a public dryer could undo all that hard work, according to a new study.A study, published in the journal Applied and Environmental Microbiology, examined 36 men’s and women’s bat...
Published: 04/13/18
Meek and Mighty Triathlon draws the young (siblings who are 7, 9 and 11) and not so young

Meek and Mighty Triathlon draws the young (siblings who are 7, 9 and 11) and not so young

The annual St. Anthony’s Triathlon has for years attracted elite athletes from around the world, making the St. Petersburg race one of the premier triathlon events in the country. There’s a big incentive to run fast, swim hard and be the best on a bi...
Published: 04/13/18
Some older patients suffer memory loss after surgery. Why does that happen?

Some older patients suffer memory loss after surgery. Why does that happen?

Two years ago, Dr. Daniel Cole’s 85-year-old father had heart bypass surgery. He hasn’t been quite the same since."He forgets things and will ask you the same thing several times," said Cole, a professor of clinical anesthesiology at UCLA and a past ...
Published: 04/13/18
Morning person or night owl? Study indicates which may have higher risks of dying sooner.

Morning person or night owl? Study indicates which may have higher risks of dying sooner.

Like staying up late? A new study suggests night owls burning the midnight oil could be more at risk for developing certain health complications, including fatal ones.The study, conducted by Northwestern Medicine and the University of Surrey in the U...
Published: 04/12/18