Consent for Labour Epidural Analgesia: An Observational Study in a Single Institution

Trumble, Julie; Lee, J.; Slater, P.; Sellors, J.; Cyna, Allan M

doi:10.1177/0310057x1504300307

Cited by 11 publications

(17 citation statements)

References 10 publications

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“…The experience of labor pain is a complex phenomenon, which is often experienced by a woman as the most challenging and severe pain [ 6 ] and the unfulfilled expectations of pain relief can affect women’s satisfaction with the childbirth experience [ 7 ]. Labor pain and resultant fear and anxiety make women more likely to have a cesarean section (CS) [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…On the other hand, some women have incorrect information and expectations regarding these methods [ 13 ]. Given that women often suffer from severe pain, anxiety, and communication barriers during childbirth, the medical staff prefers not to express the risks of analgesia in most cases when performing the analgesic procedure [ 6 , 7 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

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The effect of shared decision-making in choosing the method of labor analgesia on childbirth experience among primiparous women

2023

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Background Childbearing women reported moderate and sometimes low levels of autonomy in decision-making with their health care providers especially about their pain relief type and which may affect their childbirth experience. There is limited evidence about the effect of shared decision-making about childbirth pain relief on childbirth experience and satisfaction. Objective The present study aimed to assess the effect of shared decision-making in choosing the method of labor analgesia on childbirth experience and satisfaction among primiparous women. Methods This interventional study was conducted on 66 primiparous women with 38–42 weeks gestational age and with symptoms of labor and childbirth onset. Women were assigned into the intervention and control groups in a ratio of 1: 1 using blocked randomization. The intervention group received shared decision making about the advantages and disadvantages of labor analgesia methods, and the control group received routine care. Questionnaires, including obstetrics and demographic characteristics, Labor Agentry Scale (LAS), McKay Childbirth Satisfaction Rating Scale (MCSRS), Support and Control In Birth (SCIB) were completed. Data were analyzed by SPSS24 software and independent t-test and ANCOVA were used. Result After the intervention, the mean score of childbirth experience in the intervention group was significantly higher than that in the control group [Mean Difference (MD): 6.77, 95% CI: 2.72 to 10.82, (P <0.001)]. Further, the mean score of childbirth satisfaction in the intervention group was significantly higher than that in the control group [MD: 19.06, 95% CI: 9.63 to 28.49, (P<0.001)]. The mean score of control and support during childbirth and its subscales in the intervention group was significantly higher than that in the control group after the intervention [MD: 17.21, 95% CI: 9.40 to 25.03, (P <0.001)]. Conclusion It is recommended that mothers should be involved in treatment decisions during childbirth since they are considered an important part of providing care during labor and childbirth.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The effect of shared decision-making in choosing the method of labor analgesia on childbirth experience among primiparous women

2023

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“…However, several constraints may impact the quality of this information, in particular the relatively short time dedicated to the anesthesia consultation before delivery that predominantly targets healthy young women with an ASA 1 class. Consequently, practical information on epidural analgesia remains frequently incomplete, notably in terms of explanations about risks [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Epidural analgesia information sessions provided by anesthetic nurses: impact on satisfaction and anxiety of parturient women a prospective sequential study

et al. 2022

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Background Information on epidural analgesia delivered to parturient women is frequently incomplete, making it difficult for expectant mothers to make an appropriate choice for their delivery. We assessed the impact of a multimodal information session on epidural analgesia delegated to anesthetic nurses on new-mothers’ satisfaction. Methods We performed a prospective sequential study including parturient women who gave birth with epidural analgesia. During the first period, information on epidural analgesia was delivered by anesthetists during the scheduled anesthesia consultation, according to French standard-of-care. Then, a dedicated information session about epidural analgesia provided by anesthetic nurses was implemented. The primary endpoint was the satisfaction of women with the quality of information received. Main secondary endpoints were knowledge of women about epidural analgesia, anxiety before epidural catheter placement, and satisfaction with delivery. Results 259 and 298 women were included during the first and second periods respectively, among whom 178 and 188 were analyzed. Information on epidural analgesia delivered by anesthetic nurses was associated with improvement of new-mothers’ satisfaction with information received (9 (8–10) vs. 10 (9–10) – p < 0.001). Moreover, information delivered by anesthetic nurses was associated with decreased anxiety before epidural catheter placement (4 (1–8) vs. 3 (1–6) – p = 0.006) and increased satisfaction with delivery (8 (7–10) vs. 9 (8–10) – p = 0.01). Women’s knowledge on epidural analgesia was durably increased when information was delivered by anesthetic nurses compared to conventional information by anesthetists. After adjustment, the only variable associated with both new mothers’ satisfaction with information and delivery was the information session taught by anesthetic nurses. Conclusions Information sessions on epidural analgesia delivered by anesthetic nurses was associated with improved satisfaction of women with their delivery. Such information sessions may be used in maternity wards to improve new-mothers’ childbirth experience.

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“…Patients with an accidental dural puncture (ADP) from labour epidural placement frequently experience a post‐dural puncture headache (PDPH), which can be severe, prolonged and debilitating. It has been described as the “ worst common complication in obstetric anaesthesia ” [3] and is the risk most frequently mentioned by anaesthetists when obtaining informed consent from patients [4–6]. Audit figures from the UK in the 1999 calendar year revealed 634 cases from 38,271 epidurals (1.7%, only symptomatic cases included) [7].…”

Section: Introductionmentioning

confidence: 99%

The association between labour epidural case volume and the rate of accidental dural puncture

Sidhu

Cavadino

et al. 2021

Anaesthesia

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Summary Accidental dural puncture is a recognised complication of labour epidural placement and can cause a debilitating headache. We examined the association between labour epidural case volume and accidental dural puncture rate in specialist anaesthetists and anaesthesia trainees. We performed a retrospective cohort study of labour epidural and combined spinal‐epidural nerve blocks performed between 1 July 2013 and 31 December 2017 at Waitemata District Health Board, Auckland, New Zealand. The mean (SD) annual number of obstetric epidural and combined spinal‐epidural procedures for high‐case volume specialists was 44.2 (15.0), and for low‐case volume specialists was 10.0 (6.8), after accounting for caesarean section combined spinal‐epidural procedures. Analysis of 7976 labour epidural and combined spinal‐epidural procedure records revealed a total of 92 accidental dural punctures (1.2%). The accidental dural puncture rate (95%CI) in high‐case volume specialists was 0.6% (0.4–0.9%) and in low‐case volume specialists 2.4% (1.4–3.9%), indicating probable skill decay. The odds of accidental dural puncture were 3.77 times higher for low‐ compared with high‐case volume specialists (95%CI 1.72–8.28, p = 0.001). Amongst trainees, novices had a significantly higher accidental dural puncture complication rate (3.1%) compared with registrars (1.2%), OR (95%CI) 0.39 (0.18–0.84), p = 0.016, or fellows (1.1%), 0.35 (0.16–0.76), p = 0.008. Accidental dural puncture complication rates decreased once trainees progressed past the ‘novice’ training stage.

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Consent for Labour Epidural Analgesia: An Observational Study in a Single Institution

Cited by 11 publications

References 10 publications

The effect of shared decision-making in choosing the method of labor analgesia on childbirth experience among primiparous women

The effect of shared decision-making in choosing the method of labor analgesia on childbirth experience among primiparous women

Epidural analgesia information sessions provided by anesthetic nurses: impact on satisfaction and anxiety of parturient women a prospective sequential study

The association between labour epidural case volume and the rate of accidental dural puncture

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