Recall of risk information for epidural analgesia in labour. A questionnaire study
Abstract Number: S-15
Abstract Type: Original Research
Introduction: Legal principles that apply to the process of informed consent have evolved in recent years. Parturients now want to know all risks of labour epidural analgesia (LEA) prior to undergoing the procedure (1, 2).
Objectives: The objective was to compare the recall of risk information for LEA in parturients consented before the onset of labour with those in active labour within 24 hours of delivery.
Methods: After hospital Ethic Committee approval, primigravida having LEA before onset of established labour (IOL) and during active labour (LW) were given a standardized explanation of the procedure and risks information using the departmental and OAA leaflets. One investigator using a postnatal questionnaire within 24hrs of delivery interviewed all the patients. Questions related to knowledge and quantification of risks involved with LEA. Questions in the questionnaire were either categorical (yes/no) or scored on a scale from 1:10 to 1:100,000 (very common to very rare).
Results: During the three-month study period 42 (21 in each group) primigravida consented to participate in the study. 40 (95.2%) (LW vs IOL, 16 vs 14) of the respondents were aware of the common and very rare potential risks of LEA. Knowledge of these risks and their recall within 24 hours post delivery were not different between the groups (Figure I). All the women believed that discomfort during labour did not affected their ability to provide informed consent for LEA. 40 of the patients believe that consent process should start prior to onset of labour.
Conclusion: Despite the use of opioid analgesia and the pain of labour our patients, irrespective of the group, demonstrated high and accurate recall of the potential risks discussed. Provision of verbal plus standardized written information will serve as a useful reminder of the risks and a record of the discussion.
1. Jackson A, Henry R, Avery N et al. Informed consent for labour epidural: what labouring women want to know. Can J Anesth 2000:11; 1068–1073.
2. Kelly G D, Blunt C, Moore P A S, Lewis M. Consent for regional anaesthesia in the United Kingdom: what is material risk? Int J Obstet Anesth 2004; 13: 71–74.