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A prospective observational study to evaluate efficacy of simple questions to predict labor pain and epidural analgesia use in parturients
Abstract Number: F-03
Abstract Type: Original Research
Introduction: Labor pain is a complex phenomenon made up of multiple physical and psychosocial factors.1 Epidural analgesia is commonly used to alleviate labor pain, but there is significant inter-patient variability in responses to labor pain and epidural analgesia .2,3 One-size-fits-all approach to labor analgesia is inappropriate and a disservice to patients. Pan et al. (2013) evaluated the efficacy of three simple questions about anxiety, expected pain, and expected analgesia requirements in predicting post-cesarean section pain in patients.4 The responses from each of these pre-operative questions were useful in predicting post-cesarean section pain. Our hypothesis is that these 3 questions will reliably predict the labor pain experience and epidural analgesic use for parturients having induction of labor.
Methods: Institutional REB approval was obtained. Written informed consent has been obtained from all patients participating in this study. A total of 50 pregnant women will be recruited. A 3-question survey has been given to full term pregnant women coming for induction of labor. Participants have been asked to mark, using a 0-10 cm visual analog scale (VAS) their level of anxiety and anticipated pain during labour and delivery. Using a categorical scale of 0-5, participants have been asked to rate their anticipated epidural analgesic need as compared to the average patient. Approximately 24 hours after delivery, a follow-up interview has been conducted to assess VAS scores during labor, patient comfort level during labor (using Likert scale of 0-5) and patient satisfaction with epidural analgesia. Review of the patient charts have been done to obtain the following data: time from onset of labor to epidural analgesia, cervical dilation at time of epidural request, duration of labor, number of epidural boluses, and mode of delivery.
Results: To date, we have recruited 30/50 obstetric patients. We are continuing to recruit. We had 0 rejection and no missing data.
Discussion: This study is feasible and we anticipate that we will be able to present our final results at the May 2017 SOAP annual meeting.
1-Lowe, N. The nature of pain. American Journal of Obstetrics and Gynecology 2000; 186: 160-172
2-Pan, P., Tonidandel, A., Aschenbrenner, C., Houle, T., Harris, L., Eisenach, J. Predicting acute pain after cesarean delivery using three simple questions. Anesthesiology 2013; 118: 1170-1179
3-Carvalho, B., Zheng, M., Tagalo, L. Evaluation of experimental pain tests to predict labour pain and epidural analgesic consumption. British Journal of Anaesthesia 2012; 110 (4): 600-606
4-Pan, P., Tonidandel, A., Aschenbrenner, C., Houle, T., Harris, L., Eisenach, J. Predicting acute pain after cesarean delivery using three simple questions. Anesthesiology 2013; 118: 1170-1179