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The numeric rating scale and labor epidural analgesia
Yaakov Beilin1, Sabera Hossain, Carol A Bodian
1Departments of *Anesthesiology, †Obstetrics, Gynecology, and Reproductive Sciences, and ‡Biomathematical Sciences, Mount Sinai School of Medicine of New York University, New York City.
Anesthesia and Analgesia
|May 23, 2003
Summary
For labor epidural analgesia, most women desire more pain medication if their numeric rating scale (NRS) score is above 1. Grouping NRS scores into categories (0-1, 2-3, >3) improves clinical utility.
Area of Science:
- Pain Management
- Anesthesiology
- Obstetrics
Background:
- The verbal numeric 0-10 rating scale (NRS) is common in pain research.
- Its clinical utility for healthcare providers is not well-established.
- Desire for additional analgesia is a relevant clinical outcome.
Purpose of the Study:
- To compare the clinical relevance of the NRS with the desire for more analgesic medication.
- To evaluate the usefulness of grouped NRS scores for clinical decision-making.
Main Methods:
- Post hoc analysis of three previous studies on labor epidural analgesia.
- Collected verbal NRS scores before and 15 minutes after epidural analgesia.
- Assessed patient desire for additional pain medication at 15 minutes post-analgesia.
Main Results:
- Only 2% of patients with NRS 0-1 desired more medication.
- 51% of patients with NRS 2-3 desired more medication.
- 93% of patients with NRS >3 desired more medication.
Conclusions:
- Most women require additional analgesic medication if their labor epidural NRS score is higher than 1.
- Categorizing NRS scores (0-1, 2-3, >3) offers greater clinical utility than using individual scores.