Abstract：
OBJECTIVE: Nitrous 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.
METHODS: Single-center, prospective cohort study.
METHODS: Labor and delivery unit in a large academic medical center.
METHODS: Nulliparous patients with spontaneous or planned induction of labor.
METHODS: Parturients chose whether to use nitrous oxide during labor. At the discussion for epidural consent, 4 risks were described: headache, infection, nerve damage, bleeding.
METHODS: Labor 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.
RESULTS: Of 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).
CONCLUSIONS: The 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.
METHODS: Single-center, prospective cohort study.
METHODS: Labor and delivery unit in a large academic medical center.
METHODS: Nulliparous patients with spontaneous or planned induction of labor.
METHODS: Parturients chose whether to use nitrous oxide during labor. At the discussion for epidural consent, 4 risks were described: headache, infection, nerve damage, bleeding.
METHODS: Labor 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.
RESULTS: Of 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).
CONCLUSIONS: The 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.
摘要：
目的：一氧化二氮影响记忆和回忆。我们旨在确定在分娩期间使用一氧化二氮是否影响患者学习和回忆神经轴镇痛的风险和益处的能力。
方法：单中心，前瞻性队列研究。
方法：大型学术医疗中心的分娩和分娩单位。
方法：自发或计划引产的未产患者。
方法：产妇选择在分娩期间是否使用一氧化二氮。在硬膜外同意的讨论中，描述了4种风险：头痛，感染,神经损伤,出血。
方法：分娩疼痛评分，氧化亚氮停药的时间，在讨论硬膜外危险时记录了宫颈扩张。评估患者在产后第1天的未提示召回和提示召回硬膜外危险，并在产后第6周的未提示召回。治疗组总结了表示每种真实风险（未提示和提示召回）或干扰因素（仅提示召回）的患者数量和比例，并使用Pearsonχ2检验比较结果。
结果：在403名患者中，294（73%）没有使用一氧化二氮，109（27%）。两组相似，除了使用一氧化二氮的女性更有可能由助产士照顾，并且在硬膜外要求时疼痛评分更高。接受或未接受一氧化二氮的女性之间，未提示或提示召回硬膜外危险的得分没有差异。所有4种风险在未提示的情况下被召回，一氧化二氮组只有3%，未接受一氧化二氮组只有6%（P=.18）。
结论：使用一氧化二氮进行分娩镇痛不会对产妇回忆硬膜外放置风险的能力产生不利影响。接受一氧化二氮进行分娩镇痛的患者应被认为有资格为后续程序提供同意。
方法：单中心，前瞻性队列研究。
方法：大型学术医疗中心的分娩和分娩单位。
方法：自发或计划引产的未产患者。
方法：产妇选择在分娩期间是否使用一氧化二氮。在硬膜外同意的讨论中，描述了4种风险：头痛，感染,神经损伤,出血。
方法：分娩疼痛评分，氧化亚氮停药的时间，在讨论硬膜外危险时记录了宫颈扩张。评估患者在产后第1天的未提示召回和提示召回硬膜外危险，并在产后第6周的未提示召回。治疗组总结了表示每种真实风险（未提示和提示召回）或干扰因素（仅提示召回）的患者数量和比例，并使用Pearsonχ2检验比较结果。
结果：在403名患者中，294（73%）没有使用一氧化二氮，109（27%）。两组相似，除了使用一氧化二氮的女性更有可能由助产士照顾，并且在硬膜外要求时疼痛评分更高。接受或未接受一氧化二氮的女性之间，未提示或提示召回硬膜外危险的得分没有差异。所有4种风险在未提示的情况下被召回，一氧化二氮组只有3%，未接受一氧化二氮组只有6%（P=.18）。
结论：使用一氧化二氮进行分娩镇痛不会对产妇回忆硬膜外放置风险的能力产生不利影响。接受一氧化二氮进行分娩镇痛的患者应被认为有资格为后续程序提供同意。
