Demande d'analgésie périmédullaire par les patientes et les équipes obstétricales dans quatre régions françaises.: Partie I : demande d'analgésie

Abstract

Objective. – Epidural analgesia (EA) is widely used in France to treat the labour pain. The aim of this study was to evaluate and analyse the reasons of EA requirements by parturients and obstetricians. Study design. – An epidemiological survey was sent in all maternity units of four French areas. Patients and methods. – Forty-eight of the 84 maternity units entered the study. In each centre, 25 patients fulfilled the questionnaire and the medical team fulfilled a questionnaire about the organisation of the ward. Demands of EA by parturients during pregnancy, labour and for the next delivery were recorded, and also the offer of EA by midwifes and the possibility to move in an other town to obtain an EA. Student t-test, χ2 test and logistic regression model were used as requested. p < 0.05 was considered as significant. Results. – One thousand one hundred forty-two women entered the study. During pregnancy 79% of women asked for an EA, they were 72% during labour. Factors influencing the request of an EA were parity, educational level, pain, preanaesthetic evaluation and the size and the kind of maternity unit (university, public or private hospital). During labour, the request of an EA was more frequent when anaesthesiologists were on call in the hospital (77.7 vs 66.7%, p < 0.001). Midwifes offered EA to 69% of women. For the next delivery 79.9% of women hoped an EA, the factors of this new request were parity, pain during this labour and EA during this labour; 42.8% would be ready to move in an other town to obtain an EA. The medical indications for EA occurred in 1.8% of patients. Discussion. – The request for EA mainly comes from women. Probably, in France, the request for EA will not diminish in the future. Analgesia networks could be considered.