Harding Alison, George Ronald B, Munro Allana, Coolen Jillian, Snelgrove-Clarke Erna, Carvalho Brendan
Obstetrics and Gynaecology, Dalhousie University, Halifax, CAN.
Department of Anesthesia and Perioperative Care, University of California San Francisco (UCSF), San Francisco, USA.
Cureus. 2022 Feb 25;14(2):e22599. doi: 10.7759/cureus.22599. eCollection 2022 Feb.
Purpose Patient preferences for labor epidural analgesia (LEA) have been incompletely evaluated. This study aimed to determine the importance of various LEA outcomes to both antenatal and postpartum patients. Methods This was a cross-sectional study approved by the institutional ethics board. Questionnaires were distributed to two separate and distinct cohorts screened for eligibility: pregnant patients at an antenatal visit and postpartum patients during childbirth admission. A list of common LEA outcomes was compiled using research published in leading anesthesia journals. Participants ranked the outcomes according to perceived importance. They assigned each a number from 1 to 10 (priority ranking; 1 indicated the highest priority outcome and 10 the least). They were also asked to 'spend' $100 towards the outcomes (relative value scale), allocating more money to outcomes more important to them. Results Two hundred twenty questionnaires were completed (105 antenatal, 115 postpartum). 'Achieving desired pain relief' was the most important outcome for both cohorts. It was valued more by the postpartum cohort (Median $50 (25 - 60) vs $30 (18 - 50)). 'Overall satisfaction with the pain management,' 'experiencing a short time to achieve pain relief,' and 'experiencing a short duration of labor' received more money than avoiding various LEA-related side effects. The postpartum cohort ranked 'experiencing a short time to achieve pain relief' as more important than the antenatal cohort (Median 5 (3 - 7) vs 3 (2 - 5)). Conclusions Achieving the desired pain relief was the highest LEA outcome preference for both antenatal and postpartum patients. Avoiding side effects was less important relative to pain-related outcomes.
目的 对分娩硬膜外镇痛（LEA）的患者偏好评估尚不完整。本研究旨在确定各种LEA结局对产前和产后患者的重要性。方法 这是一项经机构伦理委员会批准的横断面研究。问卷被分发给两个单独且不同的符合条件的筛查队列：产前检查时的孕妇和分娩入院时的产后患者。使用顶级麻醉学期刊上发表的研究汇编了一份常见LEA结局清单。参与者根据感知到的重要性对结局进行排序。他们为每个结局分配一个从1到10的数字（优先级排序；1表示最高优先级结局，10表示最低优先级结局）。他们还被要求“花费”100美元用于这些结局（相对价值量表），将更多的钱分配给对他们更重要的结局。结果 共完成220份问卷（105份产前问卷，115份产后问卷）。“实现期望的疼痛缓解”是两个队列中最重要的结局。产后队列对其的重视程度更高（中位数50美元（25 - 60美元）对30美元（18 - 50美元））。“对疼痛管理的总体满意度”、“实现疼痛缓解的时间短”和“产程短”比避免各种LEA相关副作用获得了更多的资金分配。产后队列将“实现疼痛缓解的时间短”排在比产前队列更重要的位置（中位数5（3 - 7）对3（2 - 5））。结论 实现期望的疼痛缓解是产前和产后患者对LEA结局的最高偏好。相对于与疼痛相关的结局，避免副作用不太重要。
