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PARTURIENTS REPORT GREATER SATISFACTION WITH LABOR EPIDURAL ANALGESIA WHEN THE INTERVAL FROM REQUEST TO ACTIVATION IS SHORTER
Abstract Number: 101
Abstract Type: Original Research
Background: Several factors may influence maternal satisfaction with their labor epidural experience.1,2 One of these factors may be the timing of epidural placement. The hospital setting and how long it takes the anesthesia care providers to arrive once contacted for epidural placement can influence this timing. In our institution, the maternal request for epidural analgesia follows an obstetrical assessment of labor progress and readiness for epidural analgesia. This may introduce a delay, which may influence maternal satisfaction with labor analgesia. The purpose of this study is to determine the degree of patient satisfaction with labor epidural analgesia, the timing of epidural placement once requested and the relationship between the timing of epidural placement and maternal satisfaction at a teaching hospital in which resident and staff anesthesiologists are present in the hospital on call for placement of labor epidurals at all times.
Methods: This prospective study was approved by our Institutional Review Board. Resident anesthesiologists on the OB Anesthesia service gave questionnaires to patients who had received labor epidurals and who had consented to participate in the study. The questionnaires addressed satisfaction with the timing of the epidural placement and onset of pain relief compared to the patient’s request for and activation of epidural analgesia. Satisfaction was scored via a 5-point scale. Maternal satisfaction scores were compared to maternal factors including gravidity, parity and cervical dilation at the time of assessment prior to the request for epidural analgesia. In addition, the timing of the resident being paged for placement, resident arrival for placement, activation of epidural analgesia and assessment of the patient as comfortable was recorded by nursing staff. Comparisons were made between the relation of maternal satisfaction with their epidural analgesia to the progression of labor at the time of request and the intervals calculated from the times documented by the nursing staff for the performance measures.
Results: Interim analysis of questionnaires shows a trend toward greater patient satisfaction with labor epidurals in those patients who received their epidural earlier following their request for epidural analgesia.
Conclusion: Our interim results imply that patients who receive labor epidurals earlier after their request are more satisfied with their labor epidural than those who wait longer after requesting the epidural be placed. Earlier labor epidural placement may be more difficult in a setting in which anesthesia care providers require a longer time to arrive for placement, such as taking OB anesthesia call from home.
1 J Perinatal Education 2003;2003:16-21.
2 Ob Gyn 1994;84:579-82