Midwive's assessment of the upper sensory level after epidural blockade.
The ability of midwives to assess accurately the level of epidural blockade after a short period of instruction was examined. Seventy-two midwives estimated the upper level bilaterally in 100 patients, by detection of the loss of sensation to a cold stimulus. The midwife and anaesthetist were in complete agreement over the level of block in 71.5% of cases; the midwife overestimated the height of the block in 9.5% of cases, and underestimated in 19%. The midwife underestimated by three spinal segments in 1.5% of cases, and never by more. The technique was acceptable to patients and midwives alike. This procedure should enable safe management of obstetric analgesia, whoever administers top-ups; accurate detection of a block that recedes below therapeutic levels should facilitate earlier top-ups and thus reduce pain for the patient in labour.
Department of Anaesthetics, University Hospital of Wales, Health Park, Cardiff.
M J
MJ
Jones
D G
DG
Bogod
G A
GA
Rees
M
M
Rosen
D000767:Anesthesia, Epidural; D000773:Anesthesia, Obstetrical; D000776:Anesthesiology / Q000193:education; D004509:Education, Nursing, Continuing; D005260:Female; D006801:Humans; D009721:Nurse Midwives / Q000193:education; D009730:Nursing Assessment; D011247:Pregnancy; D012677:Sensation / Q000187:drug effects