Anaesthetists' experiences with the early labour epidural recommendation for obese parturients: a qualitative study

Eley, V. A., Callaway, L.K., Van Zundert, A. A. J., Lipman, J. and Gallois, C. (2016) Anaesthetists' experiences with the early labour epidural recommendation for obese parturients: a qualitative study. Anaesthesia and Intensive Care, 44 5: 620-626.

Author Eley, V. A.
Callaway, L.K.
Van Zundert, A. A. J.
Lipman, J.
Gallois, C.
Title Anaesthetists' experiences with the early labour epidural recommendation for obese parturients: a qualitative study
Journal name Anaesthesia and Intensive Care   Check publisher's open access policy
ISSN 1448-0271
0310-057X
Publication date 2016-09-01
Sub-type Article (original research)
Open Access Status Not yet assessed
Volume 44
Issue 5
Start page 620
End page 626
Total pages 7
Place of publication North Sydney, NSW, Australia
Publisher Australian Society of Anaesthetists
Collection year 2017
Subject 2700 Medicine
2706 Critical Care and Intensive Care Medicine
2703 Anesthesiology and Pain Medicine
Abstract Caring for obese pregnant women presents challenges for all medical professionals. Despite a lack of supporting evidence, expert opinion and international guidelines suggest early labour epidural insertion for obese women. Anecdotally this is not supported by all anaesthetists. This qualitative study explored the experiences of anaesthetists regarding early epidural analgesia in obese parturients, to answer the research question: Are anaesthetists consistent in how they apply early epidural analgesia in obese parturients? Personal in-depth interviews with 42 specialist anaesthetists working in south-east Queensland, Australia, were completed between February and April, 2015. Leximancerâ„¢ text analysis software applied a validated algorithm to the data to identify themes and concepts. The major themes were explored by the first author to answer the research question. Three major themes were identified: the demands associated with caring for obese women; concern regarding the anaesthetic technique used in obese women; and the importance of communication with obstetric staff. Disagreement regarding interpretation and application of early epidural analgesia was identified within this group of anaesthetists. These anaesthetists were inconsistent in how they interpreted and applied early epidural analgesia for obese parturients, with some questioning the validity of the practice. The combination of uncertainty, urgency and technical difficulty presented by obese parturients provoked anxiety in these clinicians, particularly the anticipation of unplanned general anaesthesia. Consistent anaesthetic practice could improve the implementation of early epidural analgesia in obese parturients.
Keyword Epidural analgesia
Morbid
Obesity
Obstetric anaesthesia
Pregnant women
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

 
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