Perceptions and practice of epidural analgesia among women attending antenatal clinic in FETHA

Abstract

BackgroundThe pain of childbirth is arguably the most severe pain that most women will endure in their lifetime. Epidural analgesia is widely used as an effective method of pain relief in labor. It provides almost complete relief of pain if administered timely, and does not affect the progress of the first stage labor.ObjectivesThe objective of this study was to determine the awareness and utilization of epidural analgesia in labor in pregnant women attending the antenatal clinic at Federal Teaching Hospital, Abakaliki (FETHA).MethodologyThis is a cross-sectional study involving 350 women attending the antenatal clinic between April 2016 and July 2016. A total of 335 questionnaires were correctly completed, and used for analysis.ResultsThe average age and parity of the respondents were 27.6±8.2 years and 2.4±1.8, respectively. About 58.2% of respondents were civil servants, 98.5% were married, and 74.6% had a tertiary level of education. About 43.3% of the respondents are aware of the use of epidural analgesia in labor, but only 7.5% had used it; 95% of these were satisfied and desired to use it again. The reasons responsible for the poor uptake were desire to experience natural labor, cost, and fear of side effects. However, 70% of those who had not used it expressed the desire to use it.ConclusionEpidural analgesia is one of the most effective methods of pain relief in labor. However, the present study indicates that knowledge and practice of epidural analgesia among parturients are low. Efforts should be made to raise awareness, dispel misconceptions, and subsidize the cost of providing this invaluable care in modern day obstetrics.

Factors associated with demand for epidural analgesia among women in labor at a tertiary hospital in Nnewi, South-East, NigeriaFactors associated with demand for epidural analgesia among women in labor at a tertiary hospital in Nnewi, South-East, Nigeria

“…The most predominant indication for labor epidural analgesia in this study was maternal voluntary request accounting for 66.7% of parturients who utilized epidural analgesia. This finding was similar to the report of other studies that documented patient's request as the most common reason for instituting labor epidural analgesia [5,6]. This is in keeping with the recommendations of the American Society of Anesthesiologists (ASA) and American College of Obstetrician and Gynecologists (ACOG) on labor analgesia [7,8].…”

“…Central neuraxial block (epidural analgesia) is the most versatile and effective method of labor analgesia. It involves the injection of Local anesthetics into the epidural space which consequently block the pain stimuli generated from nerve fibres of contracting uterus and dilating cervix [5][6][7][8]. Its use has been steadily increasing reaching approximately to 69% in US, Canada, Europe, Australia and Asia but not so in the low and middle income countries like Nigeria [5,6,9].…”

“…It involves the injection of Local anesthetics into the epidural space which consequently block the pain stimuli generated from nerve fibres of contracting uterus and dilating cervix [5][6][7][8]. Its use has been steadily increasing reaching approximately to 69% in US, Canada, Europe, Australia and Asia but not so in the low and middle income countries like Nigeria [5,6,9]. Against this backdrop, this study was conducted to determine the demand for epidural analgesia, indications, post-dural headache rate and factors affecting demand for epidural analgesia among women in labor who presented at the Nnamdi Azikiwe University Teaching Hospital, Nnewi, South east, Nigeria.…”

A comparison of the effects of ENTONOX inhalation and spinal anesthesia on labor pain reduction and apgar score in vaginal delivery: a clinical trial study

“…In addition, the general physical health of the neonates in both groups were assessed immediately after birth using the Apgar checklist. (form) [ 27 , 28 ]…”

Pregnant Women’s Knowledge and Attitudes toward Epidural Anesthesia in Saudi Arabia

“…10 In a study using a sample of Nigerian women attending antenatal clinics, the authors found that participants with good knowledge about EA represented 43.3%. 11 However, some studies have shown contradicting results depending, possibly, on the study population and design. Recently, Fawaz and Malas conducted a study on 200 Lebanese women in childbearing age and reported adequate knowledge about EA among the study participants.…”