Yadav Anita, Karim Habib Md Reazaul, Prakash Avinash, Jena Pinky, Aman Kumar
Department of Obstetrics and Gynecology, Andaman and Nicobar Islands Institute of Medical Sciences and GB Pant Hospital, Andaman and Nicobar Islands, India.
Department of Anaesthesiology, Andaman and Nicobar Islands Institute of Medical Sciences and GB Pant Hospital, Andaman and Nicobar Islands, India.
Saudi J Anaesth. 2018 Apr-Jun;12(2):287-291. doi: 10.4103/sja.SJA_474_17.
Pain relief is nearly regarded as the right of patients in modern day health care. Women undergo excruciating pain during normal vaginal delivery (NVD). However, the acceptance of labor analgesia (LA) has remained very poor. The present study was aimed to assess the correlation of previous exposure to such pain (parity) and school education with LA acceptance.
The present comparative study was conducted with a total 400 consented participants. A questionnaire was used to collect sociodemographic variables, acceptance/nonacceptance of LA, and the reasons for not opting for LA in upcoming delivery were noted. Participants were divided into primiparous, multiparous, and nulliparous (control). They were also grouped as per school education and compared taking illiterates as controls. Data are presented in absolute number. Fisher's exact test is used for comparison; < 0.05 was considered statistically significant.
Seventy (17.5%) multiparous and 38% primiparous participants were compared with 44.5% nulliparous women. Only 2.75% participants were illiterate. 69.50% were rural inhabitant and 81.50% believed in Hinduism. 87.14% multiparous, 84.21% primiparous, and 88.76% nulliparous women declined LA ( > 0.05). The desire to experience NVD without LA as a reason for nonacceptance was significantly less among primiparous and multiparous as compared to nulliparous ( < 0.0001), but not among literate and illiterate participants ( > 0.295 in all).
Previous labor pain significantly reduces the desire to experience NVD without LA, but still more than 80% parturients of any parity do not want LA due to one or more reasons. School education has no impact on LA acceptance.
在现代医疗保健中，缓解疼痛几乎被视为患者的权利。女性在正常阴道分娩（NVD）过程中会经历极其剧烈的疼痛。然而，分娩镇痛（LA）的接受度一直很低。本研究旨在评估既往经历过此类疼痛（产次）和学校教育与LA接受度之间的相关性。
本比较研究共纳入400名同意参与的受试者。使用问卷收集社会人口统计学变量、LA的接受/不接受情况，并记录未选择在下次分娩时使用LA的原因。受试者分为初产妇、经产妇和未产妇（对照组）。他们还根据学校教育程度进行分组，并以文盲为对照进行比较。数据以绝对数呈现。采用Fisher精确检验进行比较；P<0.05被认为具有统计学意义。
将70名（17.5%）经产妇和38%的初产妇与44.5%的未产妇进行比较。只有2.75%的受试者为文盲。69.50%为农村居民，81.50%信仰印度教。87.14%的经产妇、84.21%的初产妇和88.76%的未产妇拒绝使用LA（P>0.05）。与未产妇相比，初产妇和经产妇因希望在无LA的情况下体验NVD而拒绝使用LA作为原因的比例显著较低（P<0.0001），但在识字和文盲受试者中并非如此（所有P>0.295）。
既往分娩疼痛显著降低了在无LA的情况下体验NVD的意愿，但由于一个或多个原因，仍有超过80%的任何产次的产妇不希望使用LA。学校教育对LA接受度没有影响。
