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<script type="text/javascript" src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.boots.min.js"> </script><title>Nitrous Oxide - Drugs and Lactation Database (LactMed®) - NCBI Bookshelf</title>
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<meta name="citation_title" content="Nitrous Oxide">
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<meta name="citation_publisher" content="National Institute of Child Health and Human Development">
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<meta name="citation_date" content="2023/02/15">
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<meta name="citation_keywords" content="nitrous oxide">
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<meta name="citation_keywords" content="Dinitrogen oxide">
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<meta name="citation_keywords" content="Laughing gas">
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<meta name="citation_keywords" content="Dinitrogen monoxide">
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<meta name="citation_keywords" content="Factitious air">
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<meta name="citation_keywords" content="Nitrogen oxide">
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<meta name="citation_keywords" content="nitrogen monoxide">
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<meta name="citation_keywords" content="nitrogen protoxide">
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<meta name="citation_keywords" content="Nitrogen oxide (N2O)">
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<meta name="citation_keywords" content="Stickdioxyd">
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<meta name="citation_keywords" content="Nitrogen hypoxide">
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<meta name="citation_keywords" content="Oxido nitroso">
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<meta name="citation_keywords" content="protoxyde d'azote">
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<meta name="citation_keywords" content="Hyponitrous acid anhydride">
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<meta name="citation_keywords" content="Stickdioxyd [German]">
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<meta name="citation_keywords" content="Nitrous oxide, compressed">
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<meta name="citation_keywords" content="Oxido nitroso [Spanish]">
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<meta name="citation_keywords" content="Protoxyde d'azote [French]">
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<meta name="citation_keywords" content="Nitrous oxide, refrigerated liquid">
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<meta name="citation_keywords" content="Nitrous oxide [USP:JAN]">
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<meta name="citation_keywords" content="UNII-K50XQU1029">
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<meta name="citation_keywords" content="FEMA No. 2779">
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<meta name="citation_keywords" content="CCRIS 1225">
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<meta name="citation_keywords" content="HSDB 504">
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<meta name="citation_keywords" content="10024-97-2">
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<meta name="DC.Title" content="Nitrous Oxide">
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<meta name="description" content="Because the serum half-life of nitrous oxide in the mother is short and the drug is not expected to be absorbed by the infant, no waiting period or discarding of milk is required.[1,2] Some evidence indicates that primiparous mothers who use inhaled nitrous oxide during labor for analgesia have better breastfeeding success than mothers who do not. If used as part of general anesthesia, breastfeeding can be resumed as soon as the mother has recovered sufficiently from anesthesia to nurse. When a combination of anesthetic agents is used for a procedure, follow the recommendations for the most problematic medication used during the procedure.">
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<meta name="og:description" content="Because the serum half-life of nitrous oxide in the mother is short and the drug is not expected to be absorbed by the infant, no waiting period or discarding of milk is required.[1,2] Some evidence indicates that primiparous mothers who use inhaled nitrous oxide during labor for analgesia have better breastfeeding success than mothers who do not. If used as part of general anesthesia, breastfeeding can be resumed as soon as the mother has recovered sufficiently from anesthesia to nurse. When a combination of anesthetic agents is used for a procedure, follow the recommendations for the most problematic medication used during the procedure.">
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class="wsprkl btn" title="Jump to next match">▶</a></nav></nav></div><div id="jr-epub-interstitial" class="hidden"></div><div id="jr-content"><article data-type="main"><div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><div class="fm-sec"><h1 id="_NBK501501_"><span class="title" itemprop="name">Nitrous Oxide</span></h1><p class="fm-aai"><a href="#_NBK501501_pubdet_">Publication Details</a></p><p><em>Estimated reading time: 2 minutes</em></p></div></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><p>CASRN: 10024-97-2</p><a href="https://pubchem.ncbi.nlm.nih.gov/substance/134990167" title="View this structure in PubChem" class="img_link" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubchem"><img src="https://pubchem.ncbi.nlm.nih.gov/image/imgsrv.fcgi?t=l&sid=134990167" alt="image 134990167 in the ncbi pubchem database" /></a><div id="LM612.Drug_Levels_and_Effects"><h2 id="_LM612_Drug_Levels_and_Effects_">Drug Levels and Effects</h2><div id="LM612.Summary_of_Use_during_Lactation"><h3>Summary of Use during Lactation</h3><p>Because the serum half-life of nitrous oxide in the mother is short and the drug is not expected to be absorbed by the infant, no waiting period or discarding of milk is required.[<a class="bibr" href="#LM612.REF.1" rid="LM612.REF.1">1</a>,<a class="bibr" href="#LM612.REF.2" rid="LM612.REF.2">2</a>] Some evidence indicates that primiparous mothers who use inhaled nitrous oxide during labor for analgesia have better breastfeeding success than mothers who do not. If used as part of general anesthesia, breastfeeding can be resumed as soon as the mother has recovered sufficiently from anesthesia to nurse. When a combination of anesthetic agents is used for a procedure, follow the recommendations for the most problematic medication used during the procedure.</p></div><div id="LM612.Drug_Levels"><h3>Drug Levels</h3><p>The serum half-life of nitrous oxide is less than 3 minutes, so extensive passage into milk is unlikely.[<a class="bibr" href="#LM612.REF.1" rid="LM612.REF.1">1</a>]</p><p><i>Maternal Levels.</i> Relevant published information was not found as of the revision date.</p><p><i>Infant Levels.</i> Relevant published information was not found as of the revision date.</p></div><div id="LM612.Effects_in_Breastfed_Infants"><h3>Effects in Breastfed Infants</h3><p>Relevant published information was not found as of the revision date.</p></div><div id="LM612.Effects_on_Lactation_and_Breastmil"><h3>Effects on Lactation and Breastmilk</h3><p>A randomized, but nonblinded, study in women undergoing cesarean section compared epidural anesthesia with bupivacaine to general anesthesia with intravenous thiopental 4 mg/kg and succinylcholine 1.5 mg/kg for induction followed by nitrous oxide and isoflurane. The time to the first breastfeed was significantly shorter (107 vs 228 minutes) with the epidural anesthesia than with general anesthesia. This difference was probably caused by the anesthesia's effects on the infant, because the Apgar and neurologic and adaptive scores were significantly lower in the general anesthesia group of infants. It is not known what part nitrous oxide played in this difference in outcome.[<a class="bibr" href="#LM612.REF.3" rid="LM612.REF.3">3</a>]</p><p>A retrospective database study found that primiparous women who receive a nitrous oxide-oxygen mixture for pain during delivery in addition to routine analgesia were more likely to be breastfeeding their infants at 48 hours postpartum than women who did not receive nitrous oxide. This correlation was not found when all women were included in the analysis.[<a class="bibr" href="#LM612.REF.4" rid="LM612.REF.4">4</a>]</p><p>In a nonrandomized, nonblinded retrospective study, 62 women who chose labor with gas analgesia with 50% nitrous oxide and oxygen were compared to a control group of 124 women who did not receive gas analgesia during labor. Most of the women in the study were primiparous. Use of other labor medications was not reported. Women who received nitrous oxide had higher rates of breastfeeding and exclusive breastfeeding than those who did not at 7 days after discharge, at 1 month postpartum, and at 3 months postpartum.[<a class="bibr" href="#LM612.REF.5" rid="LM612.REF.5">5</a>]</p><p>A randomized study compared intravenous meperidine 50 mg to inhaled nitrous oxide for labor analgesia. A higher percentage of mothers receiving nitrous oxide were able to breastfeed immediately after birth (95% vs 88%), but the difference was not statistically significant. There were no differences in breastfeeding rates at 24 hours after delivery or formula use.[<a class="bibr" href="#LM612.REF.6" rid="LM612.REF.6">6</a>]</p></div><div id="LM612.References"><h3>References</h3><dl class="temp-labeled-list"><dl class="bkr_refwrap"><dt>1.</dt><dd><div class="bk_ref" id="LM612.REF.1">Hale TW. Anesthetic medications in breastfeeding mothers. <span><span class="ref-journal">J Hum Lact. </span>1999;<span class="ref-vol">15</span>:185–94.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/10578796" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10578796</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>2.</dt><dd><div class="bk_ref" id="LM612.REF.2">Rooks JP. Safety and risks of nitrous oxide labor analgesia: A review. <span><span class="ref-journal">J Midwifery Womens Health. </span>2011;<span class="ref-vol">56</span>:557–65.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/22060215" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22060215</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>3.</dt><dd><div class="bk_ref" id="LM612.REF.3">Sener EB, Guldogus N, Karakaya D, et al. Comparison of neonatal effects of epidural and general anesthesia for cesarean section. <span><span class="ref-journal">Gynecol Obstet Invest. </span>2003;<span class="ref-vol">55</span>:41–5.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/12624551" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12624551</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>4.</dt><dd><div class="bk_ref" id="LM612.REF.4">Jordan S, Emery S, Watkins A, et al. Associations of drugs routinely given in labour with breastfeeding at 48 hours: Analysis of the Cardiff births survey. <span><span class="ref-journal">BJOG. </span>2009;<span class="ref-vol">116</span>:1622–32.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/19735379" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 19735379</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>5.</dt><dd><div class="bk_ref" id="LM612.REF.5">Zanardo V, Volpe F, Parotto M, et al. Nitrous oxide labor analgesia and pain relief memory in breastfeeding women. <span><span class="ref-journal">J Matern Fetal Neonatal Med. </span>2018;<span class="ref-vol">31</span>:3243–8.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/28814150" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28814150</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>6.</dt><dd><div class="bk_ref" id="LM612.REF.6">Zuarez-Easton S, Zafran N, Garmi G, et al. Meperidine compared with nitrous oxide for intrapartum pain relief in multiparous patients: A randomized controlled trial. <span><span class="ref-journal">Obstet Gynecol. </span>2023;<span class="ref-vol">141</span>:4–10.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/36701604" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36701604</span></a>]</div></dd></dl></dl></div></div><div id="LM612.Substance_Identification"><h2 id="_LM612_Substance_Identification_">Substance Identification</h2><div id="LM612.Substance_Name"><h3>Substance Name</h3><p>Nitrous Oxide</p></div><div id="LM612.CAS_Registry_Number"><h3>CAS Registry Number</h3><p>10024-97-2</p></div><div id="LM612.Drug_Class"><h3>Drug Class</h3><p>Breast Feeding</p><p>Lactation</p><p>Milk, Human</p><p>Anesthetics, Inhalation</p></div></div><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_top_margin"><p><b>Disclaimer: </b>Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.</p></p></div></dd></dl></dl></div><div id="bk_toc_contnr"></div></div></div><div class="fm-sec"><h2 id="_NBK501501_pubdet_">Publication Details</h2><h3>Publication History</h3><p class="small">Last Revision: <span itemprop="dateModified">February 15, 2023</span>.</p><h3>Copyright</h3><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright Notice</a><p class="small"><b>Attribution Statement:</b> LactMed is a registered trademark of the U.S. Department of Health and Human Services.</p></div></div><h3>Publisher</h3><p><a href="https://www.nlm.nih.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Institute of Child Health and Human Development</a>, Bethesda (MD)</p><h3>NLM Citation</h3><p>Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006-. Nitrous Oxide. [Updated 2023 Feb 15].<span class="bk_cite_avail"></span></p></div><div class="small-screen-prev"><a href="/books/n/lactmed/LM1097/?report=reader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M75,30 c-80,60 -80,0 0,60 c-30,-60 -30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Prev</text></svg></a></div><div class="small-screen-next"><a href="/books/n/lactmed/LM1164/?report=reader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M25,30c80,60 80,0 0,60 c30,-60 30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Next</text></svg></a></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
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