Anesthesia practices for management of labor pain and cesarean delivery in France (EPIDOL): A cross-sectional survey
Authors' conclusion
Despite the high NLA rate in France, a significant proportion of women experience severe pain during labor and delivery.
Study context
- Population
- Patients delivering in randomly selected French maternity units, surveyed for 7 consecutive days, February 2016 to January 2017questionnaires from 56 units
- Participants
- 1,885 patients
- Exposure
- Cesarean delivery (CD) vs vaginal delivery (VD)
- CDn = 379
- VDn = 1,506
- Outcome
- Obstetric anesthesia practice
Methodological detailsmulticentre, prospective questionnaires, random selection of maternity units
- Multicentre
- Prospective questionnaires
- Random selection of maternity units
Main finding
As reported in the abstract
- Overall neuraxial labor analgesia (NLA) rate
- 82.5% (95% CI 82.4-82.6)
- Automated administration (PCEA/PIEB)
- 70.3% (95% CI 71.4-71.6)
- NLA effective throughout labor
- 68.2%
- Severe pain reported
- 29.4%
- Alternative approaches for labor analgesia
- 19.5% (95% CI 19.2-19.7)
Observational data: associations, not effects.
Further findings
Factors associated with severe pain during VD
| OR (95% CI) | P value | ||
|---|---|---|---|
| Obesity | 2.8 (1.0–7.5) | P < 0.04 | |
| Delivery in level I units | 0.6 (0.5–0.9) | P < 0.01 | |
| 0.10.31310Odds ratio (log scale) |
Failure of NLA during CD
| OR (95% CI) | P value | ||
|---|---|---|---|
| Failure of NLA during CDSevere pain | 10.0 (3.1–31.9) | P < 0.01 | |
| Failure of NLA during CDDissatisfaction | 26.2 (3.0–225.1) | P < 0.01 | |
| 0.050.21520Odds ratio (log scale) |
Satisfaction with vs without NLA
- Satisfaction similar in patients delivering with or without NLA
Pain during CD, scheduled vs non-scheduled
- Incidence of pain during CD similar in scheduled vs non-scheduled CD
Original publication
Anesthesia practices for management of labor pain and cesarean delivery in France (EPIDOL): A cross-sectional survey. Anaesth Crit Care Pain Med. Published 12 September 2023. doi:10.
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