Pain, Pain Relief, Satisfaction and Excellence in Obstetric Anesthesia: A Surprisingly Complex Relationship

Camann, William

doi:10.1213/ane.0000000000001676

Cited by 17 publications

(16 citation statements)

References 20 publications

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“…There are many studies that state that analgesia is not the only contributor to patient satisfaction. 2,[6][7][8][9] These are the various factors that were analysed, that may have an association with satisfaction in the society.…”

Section: Exclusion Criteriamentioning

confidence: 99%

“…Besides analgesia the relationship between the caregiver and the parturient, her involvement in decision making and meeting her expectations are important factors that affect parturient satisfaction. 7,9 In some studies when these factors were met there was higher satisfaction despite proven lesser analgesia with methods such as nitrous oxide and patient controlled remifentanil or when maternal expectations of natural birth methods were met. 6,8,20 The disparity in the availability of health services in India is still a reality.…”

Section: Complicationsmentioning

confidence: 99%

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Parturient satisfaction with labour epidural and factors affecting satisfaction scores: experiences from a tertiary centre in Southern India

George

Mani

Rai

2019

Int J Reprod Contracept Obstet Gynecol

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Background: Labour analgesia though widely practised is still not routinely administered to all parturients in India. We conducted this historical observational cross-sectional study to assess parturient knowledge and factors affecting satisfaction in those who received epidural labour analgesia; aiming at improving the services.Methods: All parturients requesting epidural labour analgesia have the catheter sited and the drug administered as per institutional protocols. A feedback form is given to these parturients, postnatally. The form consists of questions regarding her knowledge of and experience with labour analgesia, including her satisfaction score on a scale of 0 to 10. Author collected these forms and analyzed them along with information from the labour epidural register and the discharge summary.Results: The mean satisfaction score was 7.1 (SD- 2.28). 46 parturients (31.08%) had ‘low satisfaction’ (<7 score) and 102 parturients (68.9%) had ‘high satisfaction’ (≥7 score). The timing of initiation of epidural analgesia within the parturients expectations and adequate analgesia were two factors that were found to affect satisfaction scores, with statistically significant values (p=0.002 and p=0.006 respectively). Those with a very short or very long duration of labour analgesia, were more likely to give less satisfaction scores (p=0.023 and p=0.002). Only 30% of parturients had heard of labour analgesia in the past.Conclusions: In this setting good analgesia and receiving it on time are of utmost importance in those receiving epidural labor analgesia, emphasising the need for adequate analgesia and prompt initiation of the same.

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Section: Exclusion Criteriamentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

Parturient satisfaction with labour epidural and factors affecting satisfaction scores: experiences from a tertiary centre in Southern India

George

Mani

Rai

2019

Int J Reprod Contracept Obstet Gynecol

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“…Pain during labor and delivery is different for every woman, and the goals of each patient’s pain relief vary, depending on how she perceives the physical, emotional, and cognitive dimensions of pain. For the parturient, satisfaction with pain relief during labor not only may be a function of relief of physical pain but also is very dependent on practitioners’ attitudes, the parturient’s expectations, and her ability to exercise some control over the delivery 1 , 2 . Interestingly, it has been reported that partners of laboring patients have less anxiety and feel more involved in the labor process if their partners receive epidural analgesia 3 .…”

Section: Anatomy and Physiologymentioning

confidence: 99%

“…Nitrous oxide (N 2 O) has been used for decades in the United Kingdom and other countries in Europe but was almost absent from American labor suites until a few years ago. Its major purported advantage among its promoters seems to be that patients want it and perceive of it as less invasive (more “natural”) than neuraxial analgesia 2 . Availability of N 2 O for use during labor in US hospitals is increasing, but there is significant concern that the risks of N 2 O outweigh the benefits of its use 43 .…”

Section: Other Analgesia Optionsmentioning

confidence: 99%

Modern Neuraxial Anesthesia for Labor and Delivery

Meng

Smiley

2017

F1000Res

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The availability of safe, effective analgesia during labor has become an expectation for women in most of the developed world over the past two or three decades. More than 60% of women in the United States now receive some kind of neuraxial procedure during labor. This article is a brief review of the advantages and techniques of neuraxial labor analgesia along with the recent advances and controversies in the field of labor analgesia. For the most part, we have aimed the discussion at the non-anesthesiologist to give other practitioners a sense of the state of the art and science of labor analgesia in the second decade of the 21st century.

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“…Regardless of the woman's analgesic choices, unmet expectations are an important source of dissatisfaction. [ 1 ] In this review, we will focus on the pharmacological agents used for neuraxial analgesia and the different techniques of neuraxial analgesia for pain relief during labour.…”

Section: Introductionmentioning

confidence: 99%

Neuraxial techniques of labour analgesia

Gupta

Partani

2018

Indian J Anaesth

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In recent years, many neuraxial techniques have been introduced to initiate and maintain labour analgesia, with low-dose mixtures of local anaesthetics and opioids, which have improved the quality of analgesia and made it safer for both mother and neonate. An independent search of the databases of PubMed, Medline, and Cochrane controlled trial data was conducted by two researchers, and randomized controlled trials that compared different methods of neuraxial analgesia and the different techniques of maintaining labor analgesia were retrieved and analyzed. The advantages, disadvantages, and indications of each technique along with the doses of intrathecal and epidural drugs are discussed. The myths and controversies involving neuraxial labor analgesia and the current consensus on their effect on the maternal and foetal outcomes are also outlined.

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Pain, Pain Relief, Satisfaction and Excellence in Obstetric Anesthesia: A Surprisingly Complex Relationship

Cited by 17 publications

References 20 publications

Parturient satisfaction with labour epidural and factors affecting satisfaction scores: experiences from a tertiary centre in Southern India

Parturient satisfaction with labour epidural and factors affecting satisfaction scores: experiences from a tertiary centre in Southern India

Modern Neuraxial Anesthesia for Labor and Delivery

Neuraxial techniques of labour analgesia

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