150 posters, 16 sessions, 294 authors, 70 institutions
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Obstetric Anaesthesia Annual Scientific Meeting 2024
Thursday 9 - Friday 10 May 2024, Birmingham
6298940
Epidural labour analgesia efficacy: Re-audit
Poster Presenter
Authors
Part of Topic
Epidural Labour Analgesia Efficacy Re-audit
BACKGROUND
Providing effective analgesia during labour à utmost for the provision of safe obstetric care^1.
We conducted reaudit to determine factors influencing efficacy and satisfaction of epidural analgesia and compared them with the findings of 2020 audit.
METHODS
•Cross sectional convenient study
•Population: 250 obstetric patients
•Location: Mayo University Hospital (MUH)
•Duration: January 2022 to July 2022
•Patient characteristics: Age, BMI, Cervical Dilation, Parity
•Factors studied:
•Pain score at 45 minutes
•Patient satisfaction at follow up
•Lidocaine considered as test dose due to short action onset
MEASURES
Labour epidural troubleshoot
•Respond quickly.
•Always test the block first to establish block level.
•Unilateral Block: top up lying on the sore side and consider pulling of catheter 1cm.
•Perineal pain or rectal pressure: Give 50mcg fentanyl stat epidurally in 5 mls of 2% lidocaine + 5 mls of 0.25% bupivacaine plain.
•Lower Abdominal Pain: if block okay, check bladder not full or distended, if previous LSCS consider scar pain or uterine rupture and report.
•Good block but still sore: consider fentanyl 50 mcg in 0.25% bupivacaine 10 ml in sitting position.
CONCLUSIONS
•Low pain scores likely drove satisfaction (moderate negative correlation)•Recommendations
•Explore additional factors influencing satisfaction with a larger cohort à to anticipate what patients are likely to require additional analgesia strategies during labour.
•Review and implement Guidelines from The National Obstetrics Hospitals