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A survey on labor epidural test dose practices in India
Divya Jain1, Komal Gandhi1, Medha Gupta1
1Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Journal of Anaesthesiology, Clinical Pharmacology
|March 3, 2025
Summary
Practices for epidural test doses in labor analgesia vary significantly among Indian obstetric anesthesiologists. Many deviate from recommended standards, highlighting a need for clear practice guidelines to ensure patient safety during labor epidurals.
Area of Science:
- Anesthesiology
- Obstetrics
- Pharmacology
Background:
- Lack of consensus exists regarding the appropriate test dose for epidural procedures during labor analgesia.
- Current practices among obstetric anesthesiologists in India regarding test doses are not well-documented.
Purpose of the Study:
- To survey and assess the current practices of Indian obstetric anesthesiologists concerning the use of test doses for labor epidurals.
- To identify variations and deviations from recommended standards in epidural test dose administration.
Main Methods:
- A questionnaire-based survey was conducted using a Google form.
- The survey was distributed to 300 members of the Association of Obstetric Anesthesiologists (AOA) of India.
- 128 (42.7%) members responded to the survey.
Main Results:
- Only 32% of responders routinely practice labor analgesia.
- Less than 50% use a test dose for epidural catheter confirmation.
- 76.6% administer the test dose at catheter placement, with 57% using lidocaine with epinephrine.
Conclusions:
- Significant variations and deviations from recommended practices in epidural test dose administration for labor analgesia were observed in India.
- There is a clear need for the development and implementation of standardized practice guidelines.
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