Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States of America.
Department of Anesthesiology, Rush University Medical Center, 1653 W. Congress Pkwy, Chicago, IL 60612, United States of America.
Int J Obstet Anesth. 2019 May;38:66-74. doi: 10.1016/j.ijoa.2018.10.010. Epub 2018 Oct 31.
Neuraxial labor analgesia is frequently achieved after placing an epidural catheter under sterile conditions. There is no consensus on the risk versus benefit of allowing a parturient's companion to remain during the procedure. We sought to assess the effect of the presence of a companion on maternal satisfaction and anxiety during neuraxial catheter placement for labor analgesia.
Healthy nulliparous parturients planning to receive neuraxial labor analgesia after admission to labor, and who had a companion with them at the time of interview, were randomized to having a companion present or not present in the labor and delivery room during neuraxial catheter placement. Participants completed questionnaires to assess maternal anxiety, pain catastrophizing and health literacy. Satisfaction was scored on 5-point Likert scale (1- highly dissatisfied, 2- dissatisfied, 3- neutral, 4- satisfied, 5- highly satisfied).
A total of 143 participants completed the study. The Wilcoxon-Mann-Whitney odds ratio for a random pair of satisfaction scores for a woman with her companion present compared with companion not present was 1.93 (95% CI 1.30 to 2.81, P=0.001). Anxiety scores were decreased following the procedure (P=0.39) in both groups. Eighty-nine percent of women randomized to companion not present would have preferred to have a companion present (P <0.001) compared with only one with their companion present who would have preferred her companion to be not present (P=0.99).
Maternal satisfaction can be improved with the presence of a companion in the labor and delivery room at the time of neuraxial catheter placement for labor analgesia.
在无菌条件下放置硬膜外导管后，通常可以实现椎管内分娩镇痛。对于允许产妇的陪伴者在该过程中留下来的风险与益处，目前尚未达成共识。我们旨在评估陪伴者的存在对产妇在接受椎管内分娩镇痛时进行硬膜外导管放置过程中的满意度和焦虑程度的影响。
健康的初产妇计划在入住分娩病房后接受椎管内分娩镇痛，并且在接受访谈时有陪伴者陪伴，将其随机分为在放置椎管内分娩镇痛的硬膜外导管时陪伴者在场或不在场的情况。参与者完成了评估产妇焦虑、疼痛灾难化和健康素养的问卷。满意度评分采用 5 分李克特量表（1-非常不满意，2-不满意，3-中性，4-满意，5-非常满意）。
共有 143 名参与者完成了研究。在有陪伴者的情况下，随机配对的满意度评分与无陪伴者的满意度评分相比，女性的 Wilcoxon-Mann-Whitney 优势比为 1.93（95%CI 1.30 至 2.81，P=0.001）。在两组中，焦虑评分在手术后均降低（P=0.39）。与没有陪伴者相比，89%随机分配到没有陪伴者的女性更希望有陪伴者在场（P<0.001），而只有一名陪伴者在场的女性更希望她的陪伴者不在场（P=0.99）。
在进行椎管内分娩镇痛的硬膜外导管放置时，陪伴者在分娩和产房中的存在可以提高产妇的满意度。
