Parturient recall of neuraxial analgesia risks: Impact of labor pain vs no labor pain

Abstract

Study objective: Information exchange between anesthesia providers and parturients about neuraxial analgesia risks often occurs in the presence of labor pain. This study examined whether the presence of pain impacted the level of recall of information provided to parturients regarding risks of neuraxial techniques.

Design: Single-center, nonrandomized study.

Setting: Labor and delivery suite and postpartum patient rooms in a large academic medical center.

Patients: Two hundred six primigravidas admitted to our labor and delivery suites and receiving neuraxial analgesia were included.

Interventions: Informed consent for epidural and spinal placement was obtained by an obstetric anesthesia resident as per our standard practice. At the time of consent, parturients' self-reported level of pain was recorded.

Measurements: After delivery, patients completed a questionnaire asking which risks they recalled. Also queried were patient self-reported levels of anxiety at the time of consent, patient satisfaction with the informed consent process, overall satisfaction with pain control, as well as their preferred method and timing of information exchange.

Main results: Only 20.9% of the 206 participating parturients recalled all risks and none of the distractors. There was no difference in recall between those with pain and those without pain at the time of consent. Women experiencing any pain at the time of consent were more likely to be very satisfied with the communication of risks compared with women without pain (96.2% vs 85.5%, P=.005). There was no difference in the preferred method (P=.780) or timing (P=.779) of discussion of risks between women in active labor compared with women with a scheduled induction of labor.

Conclusions: Although parturients' recall of neuraxial risks did not differ based on the existence of labor pain, those having pain reported greater satisfaction with the informed consent process.

Keywords: Informed consent; Labor analgesia; Patient satisfaction.