title: Consent for labour epidural analgesia: an observational study in a single institution.
abstract: There is a wide range of practice amongst obstetric anaesthetists when obtaining consent for women requesting labour epidural analgesia. This is the first prospective observational study recording the number and types of risks mentioned and whether the risk was quantified. Statements of benefits and alternatives to the procedure were also noted. Fourteen anaesthetists, each consulting a single patient, were recorded during the process of obtaining consent and inserting the epidural. The most commonly mentioned risks (median 7) were headache/dural puncture, failure/difficulty with insertion, nerve damage, bleeding/haematoma and infection/epidural abscess. There was no difference between consultants and trainees, although consultants showed greater variance. It was uncommon for anaesthetists to state a benefit (21%) or mention an alternative option (21%), but there was usually a quantitative statement of risk (71%). Data showed a deviation from the Australian and New Zealand College of Anaesthetists guidelines and these findings may encourage anaesthetists to reflect on their own practice and guide future research.
authors.affiliation: Department of Anaesthesia, Royal Adelaide Hospital, Adelaide, South Australia.
authors.forename: J
authors.initials: J
authors.lastname: Trumble
authors.affiliation: Anaesthetic Department, Flinders Medical Centre, Adelaide, South Australia.
authors.forename: J
authors.initials: J
authors.lastname: Lee
authors.affiliation: Northampton General Hospital, Cliftonville, United Kingdom.
authors.forename: P M
authors.initials: PM
authors.lastname: Slater
authors.affiliation: Leeds General Infirmary, Leeds, United Kingdom.
authors.forename: J
authors.initials: J
authors.lastname: Sellors
authors.affiliation: Department of Women's Anaesthesia, Women's and Children's Hospital, Adelaide, South Australia.
authors.forename: A M
authors.initials: AM
authors.lastname: Cyna
mesh_terms: D015360:Analgesia, Epidural / Q000379:methods* / Q000706:statistics & numerical data; D016362:Analgesia, Obstetrical / Q000379:methods* / Q000706:statistics & numerical data; D001315:Australia; D005260:Female; D019538:Health Care Surveys / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D007258:Informed Consent / Q000706:statistics & numerical data*; D007743:Labor, Obstetric; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011247:Pregnancy; D011446:Prospective Studies; D012306:Risk
keywords: consent; epidural abscess; epidural anaesthesia; labour obstetric