Knowledge, attitude and practice regarding pharmacological methods of labor analgesia

Abstract

BACKGROUND AND OBJECTIVES: Labor pain is caused by several physiological changes and may cause psychological damage to the parturient and her relatives and, therefore, must be relieved. The objective of this study was to evaluate the knowledge, attitude, and practice of obstetricians concerning pharmacological methods of labor analgesia. METHODS: Cross-sectional study (38 obstetricians working at public maternity hospitals). A structured questionnaire was applied about knowledge, attitude and practice concerning systemic and regional pharmacological methods. The agreement magnitude was assessed by kappa coefficient. RESULTS: We observed adequate knowledge about the indications of all methods (31 to 86%), the contraindications of opioids (92%) and the adverse effects of non-opioid analgesics /antispasmodics on the fetus (76%). Concerning attitude, they agree that non-opioid analgesics/antispasmodics do not minimize labor pain (98%) but should be available at the maternity wards (89%) and that epidural analgesia is effective (100%) and should be available (94%). In practice, the indication of non-opioid analgesics/antispasmodic and epidural analgesia prevailed. In most of the requirements in each dimension (knowledge: K=-0.092 to 0.158; p=0.057 to 1.0 and attitude: K=-0.005 to 0.472; p=0.004 to 1.0), there was minimal agreement with practice, except for the non-opioid analgesics/antispasmodics (K=0.421, p=0.009), and epidural analgesia (K=0.472, p=0.004), with a moderate agreement. CONCLUSION: Knowledge was heterogeneous. The attitude was unanimous concerning the effectiveness and the need of Knowledge, attitude and practice regarding pharmacological methods of labor analgesia Conhecimento, atitude e prática em relação aos métodos farmacológicos de analgesia de parto

Utilization of Obstetric Analgesia for Labor Pain Management and Associated Factors among Obstetric Care Providers in Public Hospitals of Addis Ababa, Ethiopia: A Cross-Sectional Study

“…In line with findings from previous studies, providers with more years of experience were more likely to utilize labor analgesia [ 23 , 29 ]. This may be due to the reason that as obstetric care providers became more experienced, their level of knowledge and attitude became improved [ 30 ].…”

Efectos colaterales del tramadol versus paracetamol durante la labor de parto en gestantes atendidas en el Hospital de Especialidades José Carrasco Arteaga, periodo 2014-2019

“…Al revisar la literatura se observó que los analgésicos no opioides y los antiespasmódicos no pueden ser considerados métodos de analgesia del trabajo de parto porque no existe evidencia suficiente. Hillman et al (22) en el 2019, estudiaron en Brasil la prescripción de analgésicos no opioides durante el trabajo del parto, encontrando que aunque el 98% del personal encuestado consideraba ineficiente su uso, este medicamento es uno de los prototipos de analgesia de parto en la mente de obstetras encuestados y uno de los métodos más prescritos. Esta ambivalencia entre conocimientos y prácticas puede deberse a que estos fármacos presentan bajo riesgo para el feto y baja interferencia en el curso del trabajo de parto y, aunque no alivian el dolor, aumentan la satisfacción con la atención brindada y con el parto cuando se comparan con el placebo.…”

Pharmacological and Non-pharmacological Prescribed Methods for Labor and Delivery Pain Relief: a Cross-sectional Study in a Maternity Hospital in Brazil

“…PA is an effective form of pain relief during labor 35,36 . However, concerns regarding its safety may be a reason for refusing or not requesting PA.…”