Epidural analgesia in hispanic parturients: A single-blinded prospective cohort study on the effects of an educational intervention on epidural analgesia utilization

Abstract

Introduction: Epidural analgesia for the management of labour pain in pregnant women is a common intervention. In the United States, Hispanic parturients underutilize epidural anaesthesia when compared to other ethnic groups. Data suggest that misinformation deters many women from epidural analgesia while in labour. We hypothesized that education regarding epidural analgesia provided during a prenatal visit would normalize the utilization rates of Hispanic women while in labour. Materials and Methods: We performed a prospective, single-blinded cohort study with participants of self-described Hispanic origin in the second or third trimester. Participants (n = 45) were randomly assigned to receive an educational pamphlet on epidural anaesthesia or a control pamphlet. Following completion of their pregnancy, medical records were reviewed and participants were contacted for subjective information regarding their birth experience. Results: 38.9% of the control group was compared with 34.8% of the epidural group that received epidurals for labour analgesia (P value = 0.83), with no statistically significant differences noted between the two groups. Collection of subjective comments was notable for repeated concerns regarding complications due to neuraxial analgesia. Conclusions: A passively delivered educational pamphlet on epidural analgesia is unlikely to significantly influence Hispanic parturients' utilization of epidural analgesia. Cultural differences and values should be considered when addressing epidural analgesia to Hispanic patients. Additionally, in this patient population preemptively addressing concerns of chronic back pain may help alleviate reservations regarding epidural use.

Keywords

• Epidural anaesthesia
• epidural analgesia
• Hispanic
• obstetric anaesthesia