AB217. SOH21AS048. Patient reported efficacy of epidural analgesia in labour in University Hospital Galway (UHG)
Anaesthesia Poster Session

AB217. SOH21AS048. Patient reported efficacy of epidural analgesia in labour in University Hospital Galway (UHG)

Rachael O’Neill1, Tom Wall2, Joseph Costello1

1Department of Anaesthesia, University Hospital Galway, Galway, Ireland; 2National University of Ireland Galway, Galway, Ireland


Background: Epidural analgesia (EA) is the gold standard for labour analgesia. The literature suggests a higher failure rate with EA among maternity patients compared with general surgical patients. This audit evaluates the quality of analgesia among maternity patients in UHG.

Methods: Data were collected from 105 women who received epidurals in labour in UHG between the 25/08/2020 and 16/11/2020. The women quantified their pain score 45 minutes after insertion of the epidural. Patient satisfaction was also recorded at a follow up visit the next day. Successful analgesia was defined as a 45-minute pain score ≤3, no evidence of accidental dural puncture (ADP) or re-siting and a post satisfaction rating of satisfied/very satisfied. These were then compared against the Royal College of Anaesthetist (RCOA) standard of best practice.

Results: Seventy nine percent of (N=85) women fulfilled the criteria for successful analgesia (RCOA >/=85%). Eighty-one percent (N=86) were either satisfied/very satisfied at the follow up visit (RCOA >/=98%). There was a strong correlation between pain score at 45 minutes and patient satisfaction at follow up. Eighty percent (N=85) had a pain score of 3 or less after 45 minutes (RCOA >/=88%), while 3% (N=4) recorded a pain score of 10 at 45 minutes. Two percent (N=2) (RCOA <15%) required resitting and there was no evidence of dural puncture (RCOA <1%).

Conclusions: The results of this audit failed to meet the standards of best practice proposed by the Royal College of Anaesthetists. Reasons should be explored. Studies suggest that the following factors could be contributory; the use of low concentration local anaesthetic, unrealistic patient expectations, high BMI, cervical dilatation >7 cm and operator inexperience/inadequate training.

Keywords: Epidural; analgesia; pain; obstetrics; anaesthesia


Acknowledgments

Funding: None.


Footnote

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/map-21-ab217). The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.


doi: 10.21037/map-21-ab217
Cite this abstract as: O’Neill R, Wall T, Costello J. AB217. SOH21AS048. Patient reported efficacy of epidural analgesia in labour in University Hospital Galway (UHG). Mesentery Peritoneum 2021;5:AB217.