A survey of the knowledge attitude and practice regarding epidural labor analgesia among obstetricians at the Kenyatta National Hospital

Abstract

Background: Epidural labor analgesia is the most effective method of pain relief during childbirth and the only method that provides complete analgesia without maternal or fetal sedation. With safer drugs and better equipment its use has steadily increased over the years. It has become a milestone in obstetric analgesia and obstetricians worldwide know about it and use it. This survey looked at the respondents’ knowledge on epidural labor analgesia, their attitude towards its routine use against their ages, gender and years of experience and how often they practiced it at the Kenyatta National Hospital with determination as to whether or not their own personal experience influenced their practice. Objective: To determine the knowledge, attitude and practice of obstetricians regarding epidural labor analgesia at the Kenyatta National Hospital. Research Methodology: This study was designed as a cross-sectional descriptive survey. All consenting obstetricians were recruited into the study. Data was collected using a likert –type questionnaire at the labor ward and the obstetrics and gynaecology department of the University of Nairobi. Analysis was done using the Statistical Package for Social Scientists (SPSS) software version 20.0. Frequencies and crosstabs were used to present the data and chi square test done to look at the relationship and association between variables. Statistical significance achieved with a p-value of < 0.05. Results: Sixty obstetricians were surveyed, with a consultant to registrar ratio of 3:7 and male female ratio of 1:1. Knowledge makers of application ranged from 50-78% in relation to timing, complications and incidence of caesarean section. Only 3% practiced epidural anesthesia often but 81.7% had a positive attitude toward its routine use regardless of age, gender and years of practice with the greatest hindrance being thought to be inadequate equipment