title: An integrated pain relief service for labour: co-operation between obstetricians, anaesthetists and midwives.
abstract: Epidural injections were performed by obstetricians on 1012 patients in a pain relief service in which there was clinical co-operation between anaesthetists and obstetricians. A consultant anaesthetist collaborated in the training of staff providing the service. Midwives maintained the epidural analgesia with top-up doses as part of their traditional role in providing pain relief in labour. Eight-eight per cent of patients were fully satisfied, 10% were helped and 2% had failed epidurals. The forceps rate was 30% and the dural tap rate 1.4%. Junior obstetric staff in training grades can with adequate safeguards make a significant contribution to running an obstetric epidural service.
mesh_terms: D000767:Anesthesia, Epidural / Q000009:adverse effects; D000773:Anesthesia, Obstetrical / Q000009:adverse effects; D000776:Anesthesiology; D003299:Cooperative Behavior; D004739:England; D005260:Female; D006748:Hospital Departments; D006801:Humans; D008505:Medical Staff, Hospital; D008880:Midwifery; D009772:Obstetrical Forceps; D009774:Obstetrics; D009775:Obstetrics and Gynecology Department, Hospital; D010348:Patient Care Team; D011247:Pregnancy; D012017:Referral and Consultation