Uptake of Epidural Analgesia among Parturients at a Tertiary Centre in Port Harcourt, South-South Nigeria


Authors : Leesi Sapira-Ordu; Hyness Awoye-Godspower; Dickson Hezekiah John; Felix Chikaike Clement Wekere; Mkpe Abbey; Barinua Keekii Gbaranor; Simeon Chijioke Amadi; Stephenson Lawson; Elvis Tams Godam

Volume/Issue : Volume 10 - 2025, Issue 2 - February


Google Scholar : https://tinyurl.com/45x39rz6

Scribd : https://tinyurl.com/ydm8sw4x

DOI : https://doi.org/10.38124/ijisrt/25feb1636

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.


Abstract : Background Painless, yet progressive labour process is the desire of most parturients globally, and this can be achieved effectively with epidural analgesia especially if administered timely. Epidural analgesia provides an effective means of pain relief in labour and has been shone not to affect the progress of the first stage of labour if administered early. It is the mainstay of labour analgesia in high income countries.  Aim To assess the uptake of epidural analgesia among parturients at Rivers State University Teaching Hospital, Port Harcourt, South-South Nigeria.  Methodology This was a descriptive cross-sectional study conducted at the obstetric unit of the Rivers State University Teaching Hospital involving 393 women within 24 hours of spontaneous vaginal delivery. The women who met the eligibility criteria and gave consent for the study were recruited consecutively until the sample size was obtained. The data was collected using an interviewer administered semi-structured questionnaire and analysis was done using IBM Statistical Package for Social Sciences version 22.0 for windows. Descriptive statistics employed frequencies and proportions.  Results The mean age of the parturients was 30.30 years with standard deviation of 5.01 years, the mean parity was Para 1 and the mean gestational age at delivery was 38.12 weeks (SD-3.63 weeks) The proportion of the respondents that had heard of epidural analgesia was 42.5% while majority (57.5%) had no idea about the subject. The sources of information about the subject included; social media (27.5%), antenatal clinic (9.2%), radio/television (3.6%), family/friends (2.0%) while 0.3% heard from other sources. The uptake of epidural analgesia was 1.5%, however, 76.5% of those who did not receive this form of analgesia stated that they would have loved to receive it if offered, 16.0% did not express willingness to have accepted the method and 7.5% were unsure of whether they would have loved to receive it or not.Conclusion The uptake of epidural analgesia has been shown to be sub-optimal in low resource settings in spite of its effectiveness as labour analgesia as shown in this study. This may be as a result of insufficient knowledge or awareness of its effectiveness, which also played out in this study. This can be improved by incorporating enlightenment programs on epidural analgesia in the regular antenatal programs as this is crucial for a more pleasurable labour process.

Keywords : Analgesia, Epidural, Labour, Pain, South-South Nigeria, Uptake.

References :

  1. Silva M, Halpern SH. Epidural analgesia for labour: current techniques. Local Reg. Anesth. 2010; 3: 143-153.
  2. Leighton BL, Halpern SH. The effects if epidural analgesia labour, maternal and neonatal outcomes: A systematic review. Am J Obstet Gynecol 2002; 186: 569-577.
  3. Satpathy HK, Fleming AD, McGonigal ET, Barsoon MJ. Labour and delivery analgesia, regional and local. Drugs and Diseases. Available at; emedicine.medscape.com. last accessed in November 2024.
  4. Seijmonsbergen-Schermers AE, van den Akker T, Rydahl E, Beeckman K, Bogaerts A et al. Variations in the use of Child birth interventions in 13 high income countries: A multinational cross-sectional study. PLoS Med 2020; 17(5): e1003103.
  5. Halliday L, Nelson SM, Kearns RJ. Epidural analgesia in labour: A narrative review. Int J Gynecol Obstet 2022; 159(2): 356-364.
  6. Wang TT, Sun S, Huang SQ. Effects of epidural labour analgesia with low concentrations of local anaesthetics on obstetric outcomes: A systematic review and meta-analysis of randomized controlled trials. Anesth Analg 2017; 124: 1571-1580.
  7. Sultan P, Murphy C, Halpen S, Carvalho B. The effect of low concentrations versus high concentrations of local anaesthetics for labour analgesia on obstetrics and anaesthetic outcomes: A meta-analysis. Can J Anaesth 2013; 60: 840-854.
  8. Callahan EC, Lee W, Aleshi P, George RB. Modern labour analgesia: implications for labour outcomes and maternal-fetal health. Am J Obstet Gynecol 2023; 228(5): S1260-S1269.
  9. Kearns RJ, Kyzayeva A, Halliday LOE, Lawlor DA, Shaw M et al. Epidural analgesia during labour and severe maternal morbidity; Population based study. BJM; 385: e077190.
  10. Oladokun A, Eyelade O, Morhason-Bello I, Fadare O, Akinyemi J et al. Awareness and desirability of labour epidural analgesia: A survey of Nigerian women. IJOA, 2009; 18(1): 38-42.
  11. Ezeonu PO, Anozie OB, Onu FA, Esike CU, Mamah JE et al. Perceptions and practice of epidural analgesia among women attending antenatal clinic in FETHA. Int J Womens health 2017; 9: 905-911.
  12. Okojie NQ,Isah EC. Perception of epidural analgesia for labour among pregnant women in a Nigerian tertiary hospital setting. J West Afr Coll Surg. 2014; 4(4): 142-162.
  13. Abdurrahman A, Shehu JS, Obi OL, Abdulkarim N, Salisu I. Awareness and acceptance of epidural labour analgesia among parturients in Federal Teaching Hospital, Katsina. AJFMED 2022; 1(1): 44-49.
  14. Agbowuro KP, Ocheke AN. Awareness and desire for epidural analgesia in labour among pregnant women attending antennal clinic in Jos University Teaching Hospital. Highland Med Res J 2023; 24(1): 67-72.
  15. Tchounzou R., Innah R, Tetah HN, Ngalame A. Awareness of epidural analgesia in labour and its acceptability by parturient in a tertiary hospital in Cameroon. PAMJ Clinical Medicine 2020; 3(175). 10.11604/pamj-cm.2020.3.175.23245.
  16. Akadri A, Odelola O, Adepoju A. Labour analgesia in South West Nigeria: Methods and self-reported effectiveness. J West Afr Coll Surg. 2022; 9(4): 15-20.
  17. Fyneface-Ogan S, Mato CN, Anya SE. Epidural analgesia; views and outcomes of women in labour in a Nigerian hospital. Ann Afr Med 2009; 8(4): 250-256.

Background Painless, yet progressive labour process is the desire of most parturients globally, and this can be achieved effectively with epidural analgesia especially if administered timely. Epidural analgesia provides an effective means of pain relief in labour and has been shone not to affect the progress of the first stage of labour if administered early. It is the mainstay of labour analgesia in high income countries.  Aim To assess the uptake of epidural analgesia among parturients at Rivers State University Teaching Hospital, Port Harcourt, South-South Nigeria.  Methodology This was a descriptive cross-sectional study conducted at the obstetric unit of the Rivers State University Teaching Hospital involving 393 women within 24 hours of spontaneous vaginal delivery. The women who met the eligibility criteria and gave consent for the study were recruited consecutively until the sample size was obtained. The data was collected using an interviewer administered semi-structured questionnaire and analysis was done using IBM Statistical Package for Social Sciences version 22.0 for windows. Descriptive statistics employed frequencies and proportions.  Results The mean age of the parturients was 30.30 years with standard deviation of 5.01 years, the mean parity was Para 1 and the mean gestational age at delivery was 38.12 weeks (SD-3.63 weeks) The proportion of the respondents that had heard of epidural analgesia was 42.5% while majority (57.5%) had no idea about the subject. The sources of information about the subject included; social media (27.5%), antenatal clinic (9.2%), radio/television (3.6%), family/friends (2.0%) while 0.3% heard from other sources. The uptake of epidural analgesia was 1.5%, however, 76.5% of those who did not receive this form of analgesia stated that they would have loved to receive it if offered, 16.0% did not express willingness to have accepted the method and 7.5% were unsure of whether they would have loved to receive it or not.Conclusion The uptake of epidural analgesia has been shown to be sub-optimal in low resource settings in spite of its effectiveness as labour analgesia as shown in this study. This may be as a result of insufficient knowledge or awareness of its effectiveness, which also played out in this study. This can be improved by incorporating enlightenment programs on epidural analgesia in the regular antenatal programs as this is crucial for a more pleasurable labour process.

Keywords : Analgesia, Epidural, Labour, Pain, South-South Nigeria, Uptake.

Never miss an update from Papermashup

Get notified about the latest tutorials and downloads.

Subscribe by Email

Get alerts directly into your inbox after each post and stay updated.
Subscribe
OR

Subscribe by RSS

Add our RSS to your feedreader to get regular updates from us.
Subscribe