Epidural analgesia for labour and delivery: informed consent issues.

Can J Anaesth

Department of Anaesthesia, Queen's University, Kingston General Hospital, Ontario.

Published: September 1997

Objective: Many anaesthetists believe that informed consent for epidural analgesia during labour is inadequate. Patients are perceived to be poorly informed and unable to cope with the information given during labour for informed consent. We reviewed these two hypotheses: A) to define complications for which patients want clear information: B) to quantify the influence of pain, anxiety, opioid premedication, and the importance of level of education, on a patient's level of satisfaction with regard to the consent process: and C) to assess how satisfactory epidural pain relief correlates with satisfaction with the consent process.

Methods: Sixty patients were surveyed during the first two months after vaginal delivery by two interviewers. Questions related to demographics, severity of labour pain, level of satisfaction with the epidural anaesthetic, risk of complications and satisfaction with information received were either categorical or scored on a scale from 0 to 10.

Results: All epidural related complications were considered important to disclose (8.4/10). The level of satisfaction with the consent process was 8.1/10. Patient satisfaction was not affected by opioid premedication, anxiety, pain score, education group or level of pain relief.

Conclusion: Patients indicated they should be informed of all possible complications associated with epidural analgesia, regardless of severity or risk. In contrast to reports in the literature, non disclosure of serious risks during labour was not acceptable to parturients.

Download full-text PDF

Source
http://dx.doi.org/10.1007/BF03011961DOI Listing

Publication Analysis

Top Keywords

epidural analgesia
12
informed consent
12
level satisfaction
12
analgesia labour
8
opioid premedication
8
consent process
8
satisfaction consent
8
epidural
6
consent
6
satisfaction
6

Similar Publications

Efficacy of birthing ball exercises to reduce labor pain and cesarean rates: an updated meta-analysis of randomized controlled trials.

Arch Gynecol Obstet

January 2025

Post-Graduate Program in Health Sciences (PPGCS) Universidade do Sul de Santa Catarina, Av. Pedra Branca, 25, Palhoça, SC, Brazil.

Purpose: This updated systematic review and meta-analysis aims to evaluate the impact of a birthing ball (BB) exercises on low-risk parturients during labor, offering a more comprehensive understanding through a larger sample size, robust analysis, and focus on relevant endpoints that were underexplored in previous studies due to limited data.

Methods: We searched PubMed, Embase, Scopus, and Cochrane Central for randomized controlled trials (RCTs) comparing BB (also named Swiss ball) exercises with no intervention or standard care in parturients undergoing low-risk labor. Risk ratios (RR) and mean differences (MD) were calculated using a random-effects model.

View Article and Find Full Text PDF

Background And Objective: Pectus excavatum is a common congenital chest wall abnormality characterized by a concave appearance of the chest, and minimally invasive repair of pectus excavatum (MIRPE) is the surgical treatment of choice. A rapidly growing field of research is pain management in children undergoing MIRPE, with many shifts in practice occurring over the last decade. The primary objectives of this narrative review are to describe current methods of perioperative pain management and the development of enhanced recovery after surgery (ERAS) to improve the experience of patients undergoing MIRPE.

View Article and Find Full Text PDF

Adhering to established guidelines, regional anesthesia (RA) and pain interventions are essential for preventing or minimizing the risk of complications. This study examines neurological complications that may arise when RA or pain interventions are performed without adherence to the clinical practice guidelines. This article aimed to emphasize the relationship between deviations from standards of care in RA and neurological outcomes.

View Article and Find Full Text PDF

Background: This study aimed to assess the feasibility of real-time ultrasound-guided thoracic epidural placement.

Methods: A prospective observational study was conducted in 20 patients undergoing elective abdominal and thoracic surgery. The procedure, performed with patients in a lateral position, involved three sequential steps: (1) identification of the interlaminar gap, (2) advancement of the Touhy needle, and (3) identification of the epidural space.

View Article and Find Full Text PDF

Background: Disparities in labor epidural analgesia (LEA) management could reduce maternal satisfaction and increase risk. We compared times from the first administration of breakthrough pain medication (top-up) to LEA replacement to evaluate disparities across race.

Methods: In this retrospective cohort study (01-01-2018 to 12-31-2022), all patients with LEA and maternal race/ethnicity of non-Hispanic White or Black were eligible.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!