Background Providing effective analgesia during labour is paramount for the provision of safe obstetric We aimed to examine factors influencing efficacy and satisfaction of epidural analgesia and evaluate the safety of epidural services ID: 1046347
Download Presentation The PPT/PDF document "EXPLORING FACTORS INFLUENCING PATIENT RE..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
1. EXPLORING FACTORS INFLUENCING PATIENT REPORTED EFFICACY OF EPIDURAL ANALGESIA IN LABOUR.BackgroundProviding effective analgesia during labour is paramount for the provision of safe obstetric . We aimed to examine factors influencing efficacy and satisfaction of epidural analgesia and evaluate the safety of epidural services MethodsWe conducted a cross sectional convenience study of obstetric patients post epidural insertion in Galway (UHG) and Mayo (MUH) University Hospitals from August- December 2020. Patient characteristics (Age, BMI, Cervical Dilation, Parity), pain score at 45 minutes, and patient satisfaction at follow up were recorded. Ethics was approved locally. Tom Wall1,2,3, Rachel O’Neill1,3, Sally-Ann Sheehy2, Michelle Duggan1,2, Joseph Costello21/ School of Medicine, National University of Ireland, Galway, 2/ Dept of Anaesthesia, Mayo University Hospital. 3/ Dept Of Anaesthesia, Galway University Hospital. Results 200 obstetric patients were recruited in equal numbers from MUH and UHG with a median (IQR) age of 33 (30-36) and a median (IQR) BMI of 25 (23-29). Patients reported a median (IQR) 45-minute pain score of 2 (1-3). 125 (62.2%) patients reported ‘very-satisfied’ (5) and 38 (18.9%) reported ‘satisfied’(4) on a Likert 1-5 point scale. References1/ Royal College of Anaesthetists. Guidelines for the Provision of Anaesthetic Services Chapter 9: Guidelines for the Provision of Anaesthesia Services for an Obstetric Population. London: RCoA; 2019 (https://www.rcoa.ac.uk/gpas/chapter-9).Our StudyBest Practice RCOAFulfilled the Criteria for Successful Analgesia76.5% (N=153) ≥ 85%Indicated being satisfied/ or very satisfied at the follow- up.92.6% (N=176)≥ 98%Recorded a pain score of:3 or less at 45 minutes84.5% (N=169)≥ 88%Recorded a pain score of ≥9/10 at 45 minutes3% (N=6) Required re-siting 3% (N=6)≤15%Evidence of Dural puncture0.5%(N=1)<1% 1. 45-minute pain score </=32. No evidence of accidental Dural puncture (ADP)3. No need for re-siting 4. A post satisfaction rating of satisfied/very satisfiedVariable 1Variable 2CorrelationSignificanceInterpretation45 min pain scoreLevel of satisfaction at f/uSpearman rho = -.552p =0.001n=188Moderate negative correlation45 min pain scoreBMISpearman rho = 0.0092 p=.264 n=150Not significant 45 min pain scoreCervical Dilation at time of epiduralSpearman rho = 0.178p=.026 n=155Weak positive correlationResults Table ConclusionsLow pain scores likely drove satisfaction, it is noteworthy that there was only moderate negative correlation between the two. Exploring additional factors that influence satisfaction with a larger cohort would assist in anticipating what patients are likely to require additional analgesia strategies during labour. Neither site met RCOA best practice guidelines. A service improvement project identifying ways to improve the service, and subsequent re-audit, may be warranted.12