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Published on: January 31, 2025
253
Adherence to Practice Guidelines for Postoperative Epidural Analgesia.
Sami Ur Rehman1,2,3, Muhammad Malik1,2,3, Adeel Sabir1,2,3
1Department of Anaesthesia, Doctors Hospital and Medical Centre, Lahore, Pakistan.
Summary
This clinical audit assessed surgical epidural analgesia practices, finding adherence to guidelines in 64.9% of cases. Complications occurred in 12.98%, with motor blockade most frequent, highlighting areas for improved epidural analgesia services.
Area of Science:
- Anesthesiology and Pain Management
- Surgical Care
- Clinical Audit and Quality Improvement
Background:
- Epidural analgesia is a key component of postoperative pain management.
- Adherence to practice guidelines and monitoring complications are crucial for patient safety.
- Commonly used agents include Bupivacaine, with adjuvants like fentanyl, dexmedetomidine, and tramadol.
Purpose of the Study:
- To evaluate adherence to practice guidelines for epidural insertion.
- To assess the types of medicines used for postoperative analgesia.
- To determine the incidence of complications associated with epidural analgesia.
Main Methods:
- A clinical audit was conducted at Doctors Hospital and Medical Centre, Lahore, Pakistan.
- Data were collected from January 2021 to December 2023 using a non-probability consecutive sampling technique.
- Surgical Epidural Registers were reviewed, and calculations were performed manually.
Main Results:
- A total of 308 surgical epidurals were inserted, predominantly for orthopaedic procedures (40.6%).
- Guideline adherence for insertion level was observed in 64.9% of cases.
- The overall complication rate was 12.98%, with motor blockade being the most frequent complication.
Conclusions:
- The audit identified areas for improvement in surgical epidural analgesia services.
- Findings can guide practice changes to enhance patient outcomes.
- This audit serves as a benchmark for other epidural analgesia service providers.
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