scholarly journals Factors associated with demand for epidural analgesia among women in labor at a tertiary hospital in Nnewi, South-East, NigeriaFactors associated with demand for epidural analgesia among women in labor at a tertiary hospital in Nnewi, South-East, Nigeria

2021 ◽  
Vol 2 (1) ◽  
pp. 08-013
Author(s):  
Samuel C Ojiakor ◽  
Afam B Obidike ◽  
Kenneth N Okeke ◽  
Chioma P Nnamani ◽  
Amaka L Obi-Nwosu ◽  
...  
Keyword(s):  
Epidural Analgesia ◽  
Dural Puncture ◽  
Univariate Analysis ◽  
Mode Of Delivery ◽  
Tertiary Hospital ◽  
Labor Analgesia ◽  
University Teaching ◽  
P Value ◽  
Post Dural Puncture Headache ◽  
Labor Epidural

Background: Epidural labor analgesia has become prevalent in high income countries, but its use in low and middle income countries such as Nigeria is poorly studied. Objectives: To determine the rate of demand, indications, post-dural puncture headache rate and factors affecting demand for epidural analgesia among women in labor. Method: This was a across sectional analytical study of women in labor who were managed at Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria from 1st January 2017 to 31st December 2017. Data was obtained from women’s case files from Medical record department, labor ward, and Anesthesiology departmental records. Information obtained included total number of deliveries, mode of delivery, those that received epidural: date and time of placement, indication and number of side effects. Univariate analysis models were applied to evaluate the association between patient demographic, socioeconomic factors, clinical and demand for labor epidural analgesia. A p-value of <0.05 was taken as significant. Results: Thirty-six women out of 1,373 women received epidural labor analgesia, giving the epidural labor analgesic rate of 2.6%. The most common indication for epidural labor analgesia was maternal voluntary request which accounted for 24 (66.7%) of the population receiving analgesia. One (2.8%) parturient developed post-dural puncture headache which resolved spontaneously within 24 hours. Parturient who utilized labor epidurals were significantly older than 30 years of age (OR 3.16; 95% CI 1.51-6.62; p=0.002), Multi-parous (OR 26.65; 95% CI 3.64-100.00; p=0.001), and with higher income (OR 9.02; 95% CI 4.38-18.57; p=<0.001), but not with higher level of education (OR 0.56; 95% CI 0.27-1.16; p=0.114). Conclusion: The demand for labor epidural in the study center was low with a demand rate of 2.6% and post-dural puncture headache rate of 2.8%. The significant factors related to a parturient’s request for epidural analgesia during labor included age greater than 30 years, multiparity and higher income. There is a need for an enhanced awareness programs on obstetrics epidural analgesia.

scholarly journals A pilot study comparing dural puncture epidural with 27G Whitacre needle and conventional lumbar epidural labor analgesia

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Ashok Jadon ◽  
Surabhi Srivastawa ◽  
Neelam Sinha ◽  
Swastika Chakraborty ◽  
Apoorva Bakshi ◽  
...  
Keyword(s):  
Side Effects ◽  
Epidural Analgesia ◽  
Dural Puncture ◽  
Mode Of Delivery ◽  
Labor Analgesia ◽  
Labor Pain ◽  
Spinal Needle ◽  
Lumbar Epidural Analgesia ◽  
A New Technique ◽  
Dural Puncture Epidural

Abstract Background The dural puncture epidural (DPE) technique is relatively a new technique of labor analgesia and has been advocated with the advantage of faster onset of pain relief. However, there are differences of opinion regarding the efficacy of the DPE technique and the size of the spinal needle to be used for the DPE. Various studies have suggested that DPE can only be done with a larger gauge of a spinal needle; however, recent studies have variable observations. We have compared the conventional lumbar epidural analgesia and DPE using a 27G pencil-point needle to assess the efficacy of DPE and its possible side effects. Results The time to achieve a 50% reduction in VAS was 7.06 ± 0.79 min in group CLE (n = 15) and 5.0 ± 1.06 min in group DPE (n = 15) (difference of two means was 2.06, 95% CI [1.36, 2.75], t = 5.99, p < 0.0001). The time to achieve VAS < 3 in group CLE was 14.93 ± 1.98 min, and in the group DPE, it was 10.13 ± 1.45 min (difference of two means was 4.8, 95% CI [3.52, 6.09], t = 7.55, p < 0.0001). The mode of delivery, APGAR scores, and side effects were comparable (p > 0.05). Conclusions DPE provided faster relief of labor pain than the conventional labor epidural analgesia. There were no added side effects by DPE in conventional lumbar epidural analgesia for labor. A 27G Whitacre pencil-point needle can be used for DPE. Trial registration CTRI, CTRI/2020/08/027060. Registered on 10/08/2020. Trial registered prospectively. CTRI website URL: http://ctri.nic.in

scholarly journals Prevalence and Causes of Low Vision and Blindness among Adult Patients Attending Eye Clinic in a Tertiary Hospital in South East, Nigeria

2021 ◽  
pp. 20-28
Author(s):  
O. A. I. Otuka ◽  
N. C. Ekeleme ◽  
E. N. Akaraiwe ◽  
E. C. Iwuoha ◽  
L. I. Eweputanna ◽  
...  
Keyword(s):  
Low Vision ◽  
Statistical Significance ◽  
Tertiary Hospital ◽  
Adult Patients ◽  
University Teaching ◽  
P Value ◽  
Social Challenges ◽  
Care Givers ◽  
Significant Public Health ◽  
Eye Clinic

Background: Low vision and blindness are significant public health issues worldwide. They result in educational, occupational, and social challenges in the affected persons. Their care givers/ families are also severely affected. There is however limited data on the magnitude of visual impairment in Aba, South East Nigeria. Objective: To determine the prevalence and causes of low vision and blindness among adult patients attending eye clinic in a tertiary hospital in South East Nigeria. Materials and Methods: This was an institutional-based retrospective, descriptive study involving 457 patients who attended Abia State University Teaching Hospital eye clinic between April and September 2018. Data was obtained from patient’s hospital records within the period under study and analyzed using IBM SPSS version 25.0. Statistical significance was set at a P-value of < 0.05. Results: Data of 457 ophthalmic patients who met the inclusion criteria for this study were analyzed. Mean age of respondents was 48.5 ± 17.7 years. A total 5.4% of the patients had bilateral low vision, while 30.2% and 7% had monocular and bilateral blindness respectively. Cataract-related diagnosis, refractive errors and glaucoma (28.4%, 28.2% and 14.7%) respectively were the major causes of low vision and blindness among the patients. Statistically significant association was found between respondent’s diagnosis and age as well as occupation (P<0.001). Conclusion: Results from this study will aid in planning low vision & blindness preventive programs and improving eye care services.

scholarly journals A Study of the Awareness and Acceptabilty of Labour Epidural Analgesia amongst Antenatal Clinic Attendees in One Tertiary Hospital

2020 ◽  
pp. 3-4
Author(s):  
S. Eli ◽  
D. G. B. Kalio ◽  
N. A. E. Okeji ◽  
B. O. A. Altraide ◽  
P. Kua ◽  
...  
Keyword(s):  
Pain Relief ◽  
Epidural Analgesia ◽  
Antenatal Clinic ◽  
Tertiary Hospital ◽  
Labour Analgesia ◽  
University Teaching ◽  
Middle Income ◽  
Lack Of Information ◽  
Low Middle Income Countries ◽  
Labour Epidural Analgesia

Background: The benefits of Pain relief to parturients in labour cannot be over-emphasized. However, in low middle income countries accessibility, availability and affordability these services are not optimum. This has made it near impossible for women in labour to benefit from epidural analgesia. Aim: This study was aimed to assess the knowledge of availability and level of acceptance of labour analgesia amongst antenatal clinic attendees at the department of Obstetrics and Gynaecology, Rivers State University Teaching Hospital (RSUTH). Methods: The present observational study was conducted after informed consent was given by antenatal clinic attendees. Data was collected using a pretested questionnaire and analyzed using SPSS Version 25. Results: Response from 200 women with mean ± SD age and gestational age of 31.49 ± 4.89 years and 34.25 ± 4.75 weeks respectively. The modal Parity was 1. 56; while 106/200 (53%) were aware of pain relief in labour, 94/200 (47%) had no knowledge of pain relief in labour. Twenty eight (28/106) constituting 26.42% had knowledge of the pharmacological methods while 78 (73.59%) had non-specific ideas about pain relief in labour. Twenty six (26/28) (92.86%) of the respondents will accept epidural analgesia in labour. Conclusion: Knowledge of availability and acceptance of labour analgesia was poor. Lack of information is a major contributor for non-acceptance of labour analgesia. The inclusion and dissemination of information about labour analgesia by anaesthetists and obstetricians during antenatal classes would increase the knowledge about its availability and wide acceptance to these parturients.

scholarly journals Tramadol versus placebo for labor analgesia in low risk women: a randomized controlled trial

2019 ◽  
Vol 9 (1) ◽  
pp. 342
Author(s):  
Aastha Raheja ◽  
Krishna Agarwal ◽  
Rini Pachori ◽  
Gauri Gandhi
Keyword(s):  
Side Effects ◽  
Epidural Analgesia ◽  
Apgar Score ◽  
Controlled Trial ◽  
Caesarean Section Rate ◽  
Mode Of Delivery ◽  
Study Drug ◽  
Visual Analogue Score ◽  
Labor Analgesia ◽  
Eligibility Criteria

Background: In low- and middle-income countries epidural analgesia is generally not available and practically no form of labor analgesia is given to the majority of the parturient. The purpose of study was to evaluate the safety and efficacy of tramadol as a labor analgesic during first stage of labor.Methods: Pregnant women admitted in the labor room satisfying the eligibility criteria were randomized to receive intramuscular injection of either 100 mg tramadol or 2 ml distilled water. Visual analogue score (VAS) was assessed at the beginning and every hour till 4 hours. Pain satisfaction, duration of second stage of labor, fetal heart rate, mode of delivery, and any maternal side effects of the study drug were recorded. Neonatal evaluation using Apgar score at 1 and 5 minutes was done. For statistical analysis Student t-test, Chi Square test and Fisher’s exact test were used.Results: Total of 86 women were included in the study. The VAS scores were significantly lower in the tramadol group at 1, 2 and 3 hours after the administration. Pain relief satisfaction was significantly higher in the tramadol group. Rate of cervical dilatation, duration of the second and the third stage, need for instrumental delivery or lower segment caesarean section, rate of fetal distress and Apgar score at one and five minutes were comparable in both the groups. Nausea was significantly higher in tramadol group.Conclusions: Tramadol is a safe and efficacious drug which is inexpensive, easily available and easy to administer with few minor side effects. It can be used as a labour analgesic as an alternative to epidural analgesia in settings where epidural analgesia is not available. Trial registration: Clinicaltrials.gov PRS registration number: NCT02999594. 

Frequency of Post Dural Puncture Headache with Quincke 25g and Quincke 27g Spinal Needle after Spinal Anaesthesia

2021 ◽  
Vol 15 (11) ◽  
pp. 3116-3118
Author(s):  
Gulsher . ◽  
Riffat Zahid ◽  
Syed Mehmood Ali ◽  
Muhammad Naveed Shahzad ◽  
Amer Latif ◽  
...  
Keyword(s):  
Spinal Anesthesia ◽  
Dural Puncture ◽  
P Value ◽  
Chi Square ◽  
Post Dural Puncture Headache ◽  
Group I ◽  
Chi Square Test ◽  
Randomized Control ◽  
Group Ii ◽  
The Difference

Objective: To compare the frequency of post dural puncture headache with Quincke 25G and Quincke 27G of spinal needles for spinal anesthesia. Design of the Study: It’s a Randomized control trial. Study Settings: This study was carried out Department of anesthesiology and Intensive Care Unit, Shaikh Zayed Hospital Lahore from 29-08-2020 to 01-03-2021. Material and Methods: In this prospective study 100 patients were enrolled who were decided to undergo spinal anesthesia. Two groups were made by randomization. In patients of group I, anesthesia was administered by using 25G quincke needle while 27G quincke needle was used for patients in group II. Evaluation of patients was with regard to development of postoperative PDPH within 3-days. Groups were compared by using Chi-square test and a P-value<0.05 was taken statistically significant. Results of the Study: PDHD was seen in 14 (28%) patients in group I and in 4 (8%) patients in group II. Statistically, the difference between the two groups was significant (p<0.05).. Conclusion: Due to less frequency of PDPH with 27G needle, it should be given preference for applying spinal anesthesia over 25G needle. Keywords: Spinal anesthesia, post dural puncture headache; quincle needle.

scholarly journals Maternal quality of life in routine labor epidural analgesia versus labor analgesia on request: results of a randomized trial

2018 ◽  
Vol 27 (8) ◽  
pp. 2027-2033 ◽  
Author(s):  
A. A. S. van den Bosch ◽  
M. Goossens ◽  
K. Bonouvrié ◽  
B. Winkens ◽  
J. G. Nijhuis ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Epidural Analgesia ◽  
Randomized Trial ◽  
Labor Analgesia ◽  
Maternal Quality Of Life ◽  
Labor Epidural ◽  
Maternal Quality

scholarly journals Attitude and acceptability of assisted reproductive technology among women in a tertiary hospital in Sokoto, northern Nigeria

2021 ◽  
Vol 10 (5) ◽  
pp. 1770
Author(s):  
Amina G. Umar ◽  
Aisha N. Adamu
Keyword(s):  
Assisted Reproductive Technology ◽  
Tertiary Education ◽  
Educational Status ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Reproductive Technology ◽  
University Teaching ◽  
P Value ◽  
Cross Sectional ◽  
Living Children

Background: Infertility couple affects the couple's life, work, health, personality, identity and quality of life. The aim of the study is to determine the attitude and acceptability of assisted reproductive technology among women at the Usmanu Danfodiyo University Teaching Hospital, Sokoto.Methods: This is a cross-sectional study that involved three 350 women attending infertility clinic. They were recruited via convenient sampling method using semi-structured questionnaire. The data obtained was managed using the statistical package for social sciences version 20. A p value of <0.05 was considered statistically significant and the result obtained was presented in charts and tables.Results: Among the 350 women recruited, their ages ranged between 14-58 years with a modal age of 25-35 yeas (58.0%) and a mean of 28.59±6.7. They are mostly (78.6%), of the Hausa/Fulani ethnic group. Almost all (98.9%) of them were married and unto 40.5% of them were in polygamous marriage. Majority, 36.9% had tertiary education, and about same proportion, about half, 51.7%% were gainfully employed. About 60.3% of them were nulliparae with a mean duration of infertility of 5.07±4.8 years. Approximately half, 53.1% had secondary infertility and only about half, 51.4% will accept ART if offered. Unfortunately, among those who declined, majority (40.9%) had no reason for doing so. There was statistically significant association between educational status and acceptance of assisted reproductive technology (ART) at p value 0.02.Conclusions: The acceptance of ART in our environment is influenced by the educational status and number of living children.

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