[Analysis of resident anesthesiologists' difficulties with epidural analgesia for labor and childbirth and complication rates].
ABSTRACT 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.
Prospective, observational study in all women who asked for epidural or spinal-epidural analgesia for labor and childbirth over a 2-month period.
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%).
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.