Abstract
Author(s): Dominika Hudziak (ABEFG), Krzysztof Nowosielski (ABCDE)
Introduction. Improved availability and efficacy of epidural anesthesia changes the expectations of many women concerning labor pain control. The attending physician should provide the pregnant woman with exhaustive and objective information about the benefits and risks associated with this form of anesthesia. Irrespective of the gynecologist’s attitude, the preferences of the woman in labor must be taken into account in each case. The aim of this research was to evaluate patient satisfaction with epidural anesthesia compared with patients giving birth without the use of this form of analgesia. Material and methods. A voluntary and anonymous survey study was conducted in a group of 219 women giving natural vaginal birth to a single live fetus from January 2016 to December 2017. The study group (n=103) were patients who decided to use epidural anesthesia, and the control group (n=116) were patients who did not use this form of analgesia. The inclusion criteria were: single pregnancy, cephalic presentation and gestational age ?37 weeks. Pain intensity before and after administration of anesthesia was measured on a 10-grade visual analogue scale (VAS). Results. The study group contained significantly more patients who did not work compared with the control group. Patients performing intellectual work more rarely decided to use anesthesia (p=0.0001). Women whose partners were present during their previous labor more frequently used epidural anesthesia (p=0.003). A doctor and midwife were the main sources of knowledge for the study group, while the controls more often chose the media and friends (p=0.00001). Women who participated in antenatal classes more often chose epidural anesthesia (p=0.002). The study group patients were more satisfied with labor (p=0.001) and expressed greater willingness to use epidural anesthesia during their next childbirth (p=0.0001). Conclusions. Epidural anesthesia is an effective and safe form of labor pain relief. It does not substantially affect the frequency of obstetric complications. The place of residence, type of work, manner of obtaining information about epidural anesthesia and, in multiparous women, the presence of their partner during the previous childbirth as well as experience with various methods of labor pain relief were factors that influenced the choice of epidural anesthesia during labor.