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韩国一项关于硬膜外分娩镇痛中知情同意过程的调查。

A survey on informed consent process for epidural analgesia in labor pain in Korea.

机构信息

Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.

出版信息

Korean J Anesthesiol. 2010 Jul;59(1):34-8. doi: 10.4097/kjae.2010.59.1.34. Epub 2010 Jul 21.

Abstract

BACKGROUND

There is a legal obligation to explain the procedure and use of epidural analgesia in labor primarily due to the possibility of potential risks and associated complications. The present study details on the survey carried out to ascertain the current status of obtaining informed consent (IC) for explaining the epidural analgesia in labor.

METHODS

The present study is based on a survey through a telephone questionnaire that covered all the hospitals in Korea where the anesthesiologists' belonged to and are registered with Korean Society of Anesthesiologists. The questionnaire included questions pertaining to administration of epidural analgesia to a parturient, information on different steps of obtaining an IC, whether patient status was evaluated, when the consent was obtained, and the reasons behind, if the consent had not being given.

RESULTS

A total of 1,434 respondents took part in the survey, with a response rate of 97% (1,434/1,467). One hundred seventy-four hospitals had conducted epidural analgesia on the parturient. The overall rate of obtaining IC for epidural analgesia during labor was 85%, of which only 13% was conducted by anesthesiologists. The rate of evaluating preoperative patient status was 74%, of which 45% was conducted by anesthesiologists. Almost all of the consent was obtained prior to the procedure.

CONCLUSIONS

The rate of obtaining IC for epidural analgesia in labor is relatively high (85%) in Korea. However, it is necessary to discuss the content of the consent and the procedure followed for obtaining IC during the rapid progress of labor.

摘要

背景

由于潜在风险和相关并发症的可能性,有法律义务主要向产妇解释分娩时硬膜外镇痛的程序和用途。本研究详细介绍了为确定获得硬膜外分娩镇痛知情同意书(IC)的现状而进行的调查。

方法

本研究基于一项电话问卷调查,涵盖了韩国所有属于韩国麻醉师协会并在该协会注册的麻醉师所在的医院。问卷包括向产妇实施硬膜外镇痛、获取 IC 的不同步骤的信息、是否评估患者状况、何时获得同意以及如果未获得同意的原因等问题。

结果

共有 1434 名受访者参与了调查,应答率为 97%(1434/1467)。174 家医院对产妇进行了硬膜外镇痛。分娩时硬膜外镇痛获取 IC 的总体比率为 85%,其中仅 13%由麻醉师进行。评估术前患者状况的比率为 74%,其中 45%由麻醉师进行。几乎所有的同意书都是在程序之前获得的。

结论

韩国分娩时硬膜外镇痛获取 IC 的比率相对较高(85%)。然而,随着分娩过程的快速进展,有必要讨论同意书的内容和获取 IC 的程序。

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本文引用的文献

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Bilateral femoral neuropathy after vaginal delivery: A case report.
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"Just put it in!" Consent for epidural analgesia in labour.
Anaesth Intensive Care. 2006 Apr;34(2):147-9. doi: 10.1177/0310057X0603400224.
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Can J Anaesth. 2000 Nov;47(11):1068-73. doi: 10.1007/BF03027957.
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Informed consent for epidural analgesia in labour.
Can J Anaesth. 2000 Nov;47(11):1055-9. doi: 10.1007/BF03027955.
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Epidural analgesia for labour and delivery: informed consent issues.
Can J Anaesth. 1997 Sep;44(9):918-23. doi: 10.1007/BF03011961.

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