Nitrous oxide is a gaseous mixture harmless to inhale, ready for use, consisting of 50% oxygen and 50% nitrous oxide. Spreads rapidly in the blood, does not bind to hemoglobin, is not metabolized but is cleared from the lungs, and has a low accumulation in tissues and lipids. It’s an alternative epidural to reduce the pain of childbirth. The gas inhaled during labor allows ease the pain of contractions and to tackle the birth with less anxiety. It was recently introduced in some Italian hospitals while in Anglo is already in use for some time.

The mixture nitrous oxide and oxygen (LIVOPAN®) is used during the delivery of more than a century for the treatment of pain. In many countries it is currently the most widely used in obstetrics inhaled medication during labor:
• In the UK, 50-60% of women giving birth has used since the early 50
• In Sweden, 30% of the mothers used the nitrous as the sole analgesic during labor.
• In Australia was used by 50% of pregnant women.
He was shown that its analgesic and anxiolytic help patients overcome the fear of experiencing a wide range of painful procedures such as labor.

The LIVOPAN® is suitable for women seeking a more soft and non-invasive management of labor pain, preserving the natural character of the labor and delivery.
Is administered with a mask connected to a cylinder that contains nitrous oxide and 50% oxygen to 50%. It has a control valve that delivers gas only in the moment that woman inhales and gathers at other times.
It’s therefore the mother to determine when it needs to relieve pain and inhale the analgesic, managing in a completely autonomous administration of the drug.
The exhaled air is then channeled through a slit placed around the mask and then made to flow through a system of gas-evacuation of the room, so that there is no dispersion in the environment.

In this way, its use is safe for all operators who assist the woman in labor.

LIVOPAN® is generally used towards the end of the first stage of labor, when the contraction become stronger and the pain increases. The gas acts on the central nervous system alleviating the pain centers and stimulating the production of endorphins. Create a slight daze, she is alert and participates in all stages of labor and delivery. Nitrous oxide is a gas that, inhaled, has a slightly euphoric, anxiolytic and analgesic.

LIVOPAN® is self-administered by the mother under the supervision of midwives. Observing the trend of contractions, midwives help mothers to synchronize the drug in order to obtain the maximum analgesic effect. For the safety of the mother is important that the drug is self-administered by a mask is not fixed to the face in order to prevent any-sedation. Inhalation should commence approximately 30 seconds before the contraction so that the peak of the analgesic effect coincides with the peak intensity of the contraction, and then with the apex of pain sensation.

The timing of labor are not stretched, does not increase the use of caesarean section and tools such as the sucker. Does not affect the duration of childbirth and has a relaxing effect on the uterus. Compared to other methods of analgesia, LIVOPAN® not prolongs the duration of labor and every effect disappears rapidly at the end of inhalation

The gas LIVOPAN® has a quick and fleeting, is not metabolized and is eliminated in a short time. The inhalation should be repeated every time that starts the contraction and for the entire duration of labor.

With speed the gas does not reach the child at birth will not report any respiratory depression, or other adverse effects. No major side effects even for mom.

In very rare cases have been described fleeting symptoms of drowsiness, nausea, dizziness which disappear immediately suspending inhalation. No known adverse effects on respiration, circulation, lift capacity or other body functions.

No need for preventive examinations. During labor is not necessary the presence of the anesthetist and gynecologist. Can also be given on a full stomach, with a large margin of safety, and can be combined with other analgesics / anti-anxiety drugs, however, considering the possible increase of the sedative

The suitability for use of the gas is released from the treating gynecologist during the last ambulatory monitoring, based on the procedure used by the UOC of Obstetrics and Gynecology and, at the time, will be compiled in an informed consent signed by the doctor and patient.