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    Product reviews: Pro-Nox and Alexis CES


    Clinical Transformative Potential

    Pro-Nox has tremendous clinical transformative potential in that it has helped our obstetric service change our practice within our comfort zone to include a labor analgesia option that had previously not been available to our patients with older nitrous oxide delivery systems.


    Nitrous oxide for labor analgesia is nothing to laugh at. A 2012 Cochrane review concluded, “All women in labour should have the opportunity to choose some non-invasive method of relatively effective and safe analgesia at short notice when they wish it during labour. Inhaled pain relief, such as nitrous oxide ... may be a very useful additional method for pain relief.”2 Nitrous oxide for labor analgesia is not a panacea and will not universally replace epidurals. However, in my opinion, it should be an option everywhere from sea to shining sea. The Pro-Nox Nitrous Oxide Delivery System offers a safe, convenient starting place for this technology and I think it is worth a try.



    1. Richards W, Parbrook GD, Wilson J. Stanislav Klikovich (1853-1910). Pioneer of nitrous oxide and oxygen analgesia. Anaesthesia. 1976;31(7):933–940.

    2. Klomp T, van Poppel M, Jones L, Lazet J, Di Nisio M, Lagro-Janssen AL. Inhaled analgesia for pain management in labour. Cochrane Database Syst Rev. 2012 Sep 12;9.


    James Greenberg, MD
    Dr. Greenberg is Chief, Division of Gynecology, Brigham & Women’s Faulkner Hospital, and Associate Professor, Harvard Medical School, ...


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