The effect of studying Obstetrics on the opinion of students regarding the use of epidural anaesthesia during a natural labour
Keywords:
Epidural anaesthesia, 1st cycle studies, obstetrics, degree programmesAbstract
Introduction and Objective: The pain of labour is one of the most intense pain sensations in a woman’s life. The pain may affect the condition of both the mother and the child. The most effective pain control method at present is epidural anaesthesia (EA). The aim of the study was to assess the influence of the content of courses for Obstetrics students on their opinions regarding epidural anaesthesia.
Material and Methods: The study involved 170 students of Obstetrics at Warsaw Medical University, with 80 (47%) first-year students (1Y) and 90 (53%) third-year students (3Y). The study participants voluntarily completed an anonymous questionnaire designed by the authors. Statistical analysis (STATISTICA 9.0) used the non-parametric Manu-Whitney U test (p<0.05).
Results: Both 1Y (37%) and 3Y (54%) students regarded EA as the most effective method of pain control. A higher proportion of 3Y (84%) than 1Y students declared familiarity with subarachnoid anaesthesia (p<0.009) and opioids (p<0.001). 3Y students (54%) pointed to EA as the most effective method more often (p<0.024) than 1Y students (37%). Situations that would make the students use EA during delivery were delivery in a patient with a low pain threshold (1Y 72%, 3Y 81%), and prolonged delivery (1Y 47%, 3Y 59%). 53% of the students stated that EA should be free of charge for patients with medical indications, 38% believed that EA should be free of charge. 77% of the students believed that lack of funding is the reason why EA is not used in Poland. 42% of 3Y and 12% of 1Y students (p<0.001) pointed to staff shortages. 1Y students pointed to interference with the natural course of delivery as the reason for not using EA significantly more often (37%) than 3Y students (8%).
Conclusions: 1. 1Y students expressed a negative attitude to EA, which may be due to the fact that class topics at the beginning of studies are solely concerned with natural birthing. 2. Course content during 1st cycle studies did influence students’ opinions regarding the use of EA during a natural delivery. 3. 3Y students were in favour of using EA, which may be associated with greater practical experience and more extensive theoretical knowledge.
Downloads
References
Waldenstrom U, Hildingsson I,Rubertsson C. A negative birth experience: prevalence and risk factors in national sample. Birth 2004; 1: 17-27.
Sołek-Pastuszka J, Kępiński S, Makowski A. Porównanie jakości znieczulenia u rodzących otrzymujących remifentanil metodą analgezji dożylnej sterowanej przez pacjenta lub ciągłego znieczulenia zewnątrzoponowego. Anestezjologia Intensywna Terapia 2009; 41: 84-88.
Bremborowicz G.H. Znieczulenie w trakcie porodu. Położnictwo i Ginekologia. PZWL, Warszawa, 2008, s. 355-366.
Kotarski J, Dobrogowski J, Poręba R. Rekomendacje Polskiego Towarzystwa Badania Bólu oraz PTG dotyczące postępowania przeciwbólowego w ginekologii i położnictwie cz. II Leczenie bólu u kobiet rodzących ciężarnych i w połogu. Ginekologia Polska 2008; 8: 567-577.
Suchocka L. Psychologiczne aspekty bólu. Ból 2008; 9: 24-31.
Adamczyk AM, Mayzner-Zawadzka E. Wytyczne dla analgezji zewnątrzoponowej w Polsce. Ból 2003; 81: 81-84.
Maciejewski D. Przeobrażenia anestezji położniczej w Polsce. Ból 2009; 10: 55-59.
Mayzner-Zawadzka E, Kruszyński Z, Gaca M. Analgezja zewnątrzoponowa porodu – wytyczne. Anestezjologia Intensywna Terapia 2009;2: 114-118.
Billert H, Gaca M, Miluska J. Ocena lęku u rodzących zdecydowanych na analgezję zewnatrzoponową. Ginekologia Polska 2007; 7: 532-537.
Zielińska-Magielska B. Znieczulenie zewnątrzoponowe porodu. Położna Nauka i Praktyka 2009; 3: 12-15.
May A. Znieczulenie zewnątrzoponowe porodu. medica Press, Bielsko Biała, 1994.
Pschyrembel W, Dudenhausen JW. Zwalczanie bólu porodowego. Położnictwo praktyczne i operacje położnicze. PZWL, Warszawa, 1997, s. 238-244.
Gaca M. Znieczulenie w trakcie porodu. Ginekologia Praktyczna 2009; 1: 9-13.
Treść ustawy z 5 grudnia 1996 r. o zawodach lekarza i lekarza dentysty (tekst jednolity Dz. U. z 2005 r. Nr 226, poz. 1943). Ustawa z 27 sierpnia 2004 r. o świadczeniach opieki zdrowotnej finansowanych ze środków publicznych (Dz. U. Nr 210, poz. 2135, z późn. zm.)
Opieka okołoporodowa w Polsce w świetle akcji "Rodzić po ludzku" 2006; O bólu porodowym i metodach jego łagodzenia Dostępny pod adresem: http://www.rodzicpoludzku.pl/files/Sprawozdania/sprawozdanie%202006s.doc [20.05.2010]
Kruszyński Z. Znieczulenie przewodowe porodu. Anestezjologia położnicza, położnicze stany naglące. PZWL, Warszawa, 2006, s. 33-43.
Zundert AV, Bruinsma A, Kruchten P. Neurological complications of central neuraxial blockade. Ból 2009; 10: 35-42.
Dawley B, Hendrix A. Intracranial Subdural Hematoma After Spinal Anesthesia in a parturient. Obstetrics and Gynecology 2009; 113: 570-573.
Rykowski JJ. Unintended central blockade; subdural anaesthesia. Ból 2009; 10: 114-115.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2011 Medical Journal of the Rzeszow University and the National Medicines Institute, Warsaw
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our open access policy is in accordance with the Budapest Open Access Initiative (BOAI) definition: this means that articles have free availability on the public Internet, permitting any users to read, download, copy, distribute, print, search, or link to the full texts of these articles, crawl them for indexing, pass them as data to software, or use them for any other lawful purpose, without financial, legal, or technical barriers other than those inseparable from having access to the Internet itself.
All articles are published with free open access under the CC-BY Creative Commons attribution license (the current version is CC-BY, version 4.0). If you submit your paper for publication by the Eur J Clin Exp Med, you agree to have the CC-BY license applied to your work. Under this Open Access license, you, as the author, agree that anyone may download and read the paper for free. In addition, the article may be reused and quoted provided that the original published version is cited. This facilitates freedom in re-use and also ensures that Eur J Clin Exp Med content can be mined without barriers for the research needs.
