As her daughter arrived Monday and the pain rose sharply, Julia Casadonte found relief from an easygoing painkiller best-known to dental patients and jam-band fans: nitrous oxide.
Over six or seven hours, the new Raleigh mother took roughly 50 breaths from a tank of the substance sometimes called laughing gas. It marked a first for Rex Hospital and for Wake County.
Far milder than an epidural, the gas lasts only about 30 seconds and is self-administered, meaning a mother fits a mask over her face when the miracle of life grows too harsh to bear.
“It kind of takes the edge off,” said Casadonte, 30. “It’s a little of a lightheaded feeling, more mental than physical.”
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Rex is the first Wake County hospital with labor aided by nitrous oxide. Prior to Monday, gas in the Triangle had been used only in academic medical centers such as UNC Hospitals, which has offered it for about a year.
But outside the United States, nitrous oxide stands as the most popular analgesic, said Dr. Kirk Matthews, a Raleigh obstetrician-gynecologist. In Europe, 80 percent of hospitals use it. But because it offers only a temporary reprieve, it hasn’t gained popularity here until recently.
“American patients have always looked for more complete pain control,” he said.
The gas has a long history as a recreational drug, dating to the late 18th century, when medical students would test its giddy effects, leading to “laughing gas” parties popular among the upper class. English poet Samuel Taylor Coleridge experimented with it, likening the experience to “returning from the snow into a warm room.”
Samuel Colt, famed revolver inventor, once toured the country giving doses to paying crowds. Nitrous oxide remains a staple drug at rock shows, having led to 12 arrests at a Phish concert earlier this month.
It has nearly as long a history in dentistry. In 1844, New England dentist Horace Wells first tested it on himself while having a tooth pulled by a traveling circus performer, then, having felt nothing, tried it out on his patients.
But the experience is much different for a birthing mother, Matthews said. The dosage comes in a quick breath rather than a continuous flow, and the inhaled gas is half oxygen.
It is ideal, he said, for mothers who want to avoid an epidural or hold off on the procedure until later in labor.
Coming into her own labor, Casadonte wanted an experience that was milder and more natural than an epidural would create, but not necessarily drug-free altogether. Nitrous oxide seemed like a good half measure that would allow her to walk and move her baby into position.
She arrived at Rex at 4 a.m. Monday and started the nitrous about three hours later.
“I really liked it,” she said. “It helped me get through seven hours of labor.”
“When you put the mask down,” said her husband, Chase, “within five seconds you were back to completely lucid.”
Her labor took 12 hours, and she opted for an epidural about three-quarters of the way through. At the end came Lucy – 8 pounds, 14 ounces – named for a Beatles song like her mother.
And once that happened, Casadonte wasn’t thinking about being the first nitrous oxide patient. She was focused on her first child.
Josh Shaffer: email@example.com or 919-829-4818