We’re about to have our third child. And like all anxious expecting couples, we’re considering our options for the birth. Home or hospital? Anaesthetic or natural? Daily Telegraph or Guardian (for me)?
My wife had epidurals with our previous two children but we’re flirting with having just gas and air this time (easy for me to say).
Gas and air - as you know, an equal mix of nitrous oxide and oxygen - has a long and interesting history.
Nitrous oxide, or laughing gas, was first used as a medical analgesic in 1844 by American dentist Horace Wells. It grew in popularity in the late 1800s.
But the hypoxia caused by a lack of oxygen was a real problem until it was discovered that an oxygen content of at least 21% (the same percentage as in air) reduced its occurrence significantly.
The anaesthetist Arthur Ernest Guedel first described the use of self-administration of a nitrous oxide and oxygen mix in 1911. But, it was not until 1961 that the first paper was published by Michael Tunstall et al describing the administration of a pre-mixed 50:50 nitrous oxide and oxygen mix, which led to the commercialisation of the product.
Its analgesic effect is strong - said to be equivalent to 15 mg of subcutaneous route morphine - and is characterised by rapid onset and offset.
This is great if you’re having contractions in labour.
But it’s not great for patients with a bowel obstruction, pneumothorax, middle ear or sinus disease or who’ve recently been scuba diving.
Or, rather importantly, if you’re an SHO who is on duty in a children’s ward.
Dr Chahal, as you now realise, there are better ways of impressing a nurse than holding an “Entonox” party…
Tags: fitness to practise, Humour
