[Analysis of resident anesthesiologists' difficulties with epidural analgesia for labor and childbirth and complication rates].
OBJECTIVE
To analyze the number of attempts to provide an epidural or spinal-epidural block for labor and complication rates when the procedures are performed by resident or staff anesthesiologists.


METHODS
Prospective, observational study in all women who asked for epidural or spinal-epidural analgesia for labor and childbirth over a 2-month period.


RESULTS
We enrolled 1097 women. The procedure was performed by residents in 74.6% of the cases. The mean (SD) number of attempts needed to perform the technique was 1.46 (0.9) regardless of whether the anesthesiologist was a resident or on staff. Accidental dural puncture occurred in 14 cases (1.3%). The most common complication during puncture was paresthesia (34.1%), and the difference between the rates for staff anesthesiologists and residents was not significant. Asymmetric analgesia was the most common complication during the dilatation phase (37.4%).


CONCLUSIONS
The number of attempts needed was 1.28 for staff anesthesiologists and 1.52 for residents (P = .02). The differences between the 2 groups in the incidences of complications (blood noted during puncture, accidental dural puncture, pain during expulsion, repeat epidural or spinal puncture, nausea, or back pain) were not significant.
De Blas García
M
M
Servicio de Anestesiología y Reanimación, Hospital Universitario "La Paz", Madrid.
Guasch Arévalo
E
E
Martínez Jiménez
F
F
Gredilla Díez
E
E
Gilsanz Rodríguez
F
F
D000328:Adult; D015360:Analgesia, Epidural; D016362:Analgesia, Obstetrical; D000776:Anesthesiology / Q000193:education*; D005260:Female; D006801:Humans; D007396:Internship and Residency; D007744:Obstetric Labor Complications / Q000628:therapy*; D011247:Pregnancy; D011446:Prospective Studies