|Epidural Analgesia for Management of Labour Pain: Determinants and Deterrents Among Obstetricians in Nigeria|
|Okechukwu B. Anozie1, Lucky. O. Lawani1, Johnbosco. E. Mamah1, Chidi. O. Esike1, Olisaemeka. P. Ezeonu1, Justus. N. Eze2, Robinson. C. Onoh1, Onwe E. O.3, O.R.Anozie4, Richard.L.Ewah5|
|1Department of Obstetrics & Gyneacology, Federal Teaching Hospital Abakaliki, Ebonyi State
2Department of Obstetrics & Gyneacology, Ebony State University Abakaliki, Ebonyi State
3Department of Paediatrics Federal Teaching Hospital, Abakaliki
4Department of Radiology, Federal Teaching Hospital Abakaliki, Ebonyi State
5Department of Anasthesia, Federal Teaching Hospital, Abakaliki, Ebonyi State
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Keywords : Labour, Analgesia, Epidural, Practice, Obstetricians, Nigeria
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Objectives: To assess the utilisation of epidural analgesia, its determinants and deterrents among Obstetricians.
Materials and Methods: A questionnaire-based cross-sectional study was conducted among Obstetricians who attended the Annual Scientific Conference of the Society of Gynaecology and Obstetrics of Nigeria in 2016. A total 324 questionnaires were analysed with Epi-info statistical software.
Results: Knowledge of epidural analgesia was high (100%), while availability was 77.8%, however only about 25.9% routinely prescribe it. Majority (96.2%) of the respondents practiced in tertiary health facilities in urban locations (94.1%). Almost three-quarter (237/324; 73.1%) of respondents were males, while 87(26.9%) were females. Female Obstetricians were more likely to prescribe epidural analgesia for pain management in labour (68.9% vs 63.3%, p-value=0.001). The greatest impediment to its use was cost (69.4%), lack of skill (27.8%), client’s refusal (13.9%) and fear of complications (10.2%). Over 95% of Obstetricians whose patients had used epidural analgesia expressed satisfaction and good feto-maternal outcome of labour.
Conclusion: There is a huge disparity between knowledge of epidural analgesia and actual practice among Obstetrician. In closing this gap, Obstetricians must do more to adequately education patients on the options of pain relief and routinely offer it for a satisfying birth experience.
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