Ambulatory epidural analgesia during uncomplicated obstetric labour: Feasibility study at the Centre hospitalier intercommunal Villeneuve Saint Georges

Abstract

Objective: The study was carried out to assess the feasibility of walking under obstetric epidural analgesia at the Villeneuve St Georges Inter-communal Hospital (VSGIH). Methods: The study population consisted of parturient who consulted a labour and delivery unit during the study period, and the nursing staff of this ward. Results: During the study period, only 33 women (37%) out of a possible 87 agreed to walk around, 40 did not do so because they were tired and 16 refused to take part in the study. Of the 33 patients recruited, 5 did not walk because of fatigue at the time the procedure was carried out. The mean age was 30.33 years, all classified as ASA II. More than 78% were undergoing first or second gestures, and almost 50% had their epidural inserted at 3cm cervical dilatation. Ambulation took place during the day in 90% of patients, with 50% of them completing a single slot for an average duration of 69.5 minutes in the 1st slot. The main reason for stopping walking was fatigue in 36% of patients. 96% of patients were not aware of the possibility of ambulation under epidural during labour, and all women were satisfied after ambulation. More than a third of the nursing staff who took part in the study (66.7%) thought that the walking under obstetric epidural analgesia (WUOEA) was safe, and 15 of them (71.4%) thought that it was easy to use. The obstacles to implementing the WUOEA were: the absence of wireless monitoring (42.9%), very restrictive selection criteria (23.8%), lack of patient motivation (19%), and fear of the safety of the technique. Conclusion: The effective and permanent introduction of ambulatory epidural analgesia is possible at the Villeneuve Saint Georges Intercommunal Hospital. New equipment, in particular the wireless monitor, is required for this purpose.