Effect of companion presence on maternal satisfaction during neuraxial catheter placement for labor analgesia

a randomized clinical trial

E. Morell, Feyce Mabel Peralta, Nicole Higgins, A. Suchar, P. Fitzgerald, R. J. McCarthy*

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Background: Neuraxial labor analgesia is frequently achieved after placing an epidural catheter under sterile conditions. There is no consensus on the risk versus benefit of allowing a parturient's companion to remain during the procedure. We sought to assess the effect of the presence of a companion on maternal satisfaction and anxiety during neuraxial catheter placement for labor analgesia. Methods: Healthy nulliparous parturients planning to receive neuraxial labor analgesia after admission to labor, and who had a companion with them at the time of interview, were randomized to having a companion present or not present in the labor and delivery room during neuraxial catheter placement. Participants completed questionnaires to assess maternal anxiety, pain catastrophizing and health literacy. Satisfaction was scored on 5-point Likert scale (1- highly dissatisfied, 2- dissatisfied, 3- neutral, 4- satisfied, 5- highly satisfied). Results: A total of 143 participants completed the study. The Wilcoxon–Mann–Whitney odds ratio for a random pair of satisfaction scores for a woman with her companion present compared with companion not present was 1.93 (95% CI 1.30 to 2.81, P=0.001). Anxiety scores were decreased following the procedure (P=0.39)in both groups. Eighty-nine percent of women randomized to companion not present would have preferred to have a companion present (P <0.001)compared with only one with their companion present who would have preferred her companion to be not present (P=0.99). Conclusion: Maternal satisfaction can be improved with the presence of a companion in the labor and delivery room at the time of neuraxial catheter placement for labor analgesia.

Original languageEnglish (US)
Pages (from-to)66-74
Number of pages9
JournalInternational Journal of Obstetric Anesthesia
Volume38
DOIs
StatePublished - May 1 2019

Fingerprint

Analgesia
Catheters
Randomized Controlled Trials
Mothers
Delivery Rooms
Anxiety
Parturition
Catastrophization
Health Literacy
Consensus
Odds Ratio
Interviews

Keywords

  • Catheter placement
  • Companion presence
  • Labor analgesia
  • Neuraxial

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Anesthesiology and Pain Medicine

Cite this

@article{aff4301ee9cf483993656f2273494bd9,
title = "Effect of companion presence on maternal satisfaction during neuraxial catheter placement for labor analgesia: a randomized clinical trial",
abstract = "Background: Neuraxial labor analgesia is frequently achieved after placing an epidural catheter under sterile conditions. There is no consensus on the risk versus benefit of allowing a parturient's companion to remain during the procedure. We sought to assess the effect of the presence of a companion on maternal satisfaction and anxiety during neuraxial catheter placement for labor analgesia. Methods: Healthy nulliparous parturients planning to receive neuraxial labor analgesia after admission to labor, and who had a companion with them at the time of interview, were randomized to having a companion present or not present in the labor and delivery room during neuraxial catheter placement. Participants completed questionnaires to assess maternal anxiety, pain catastrophizing and health literacy. Satisfaction was scored on 5-point Likert scale (1- highly dissatisfied, 2- dissatisfied, 3- neutral, 4- satisfied, 5- highly satisfied). Results: A total of 143 participants completed the study. The Wilcoxon–Mann–Whitney odds ratio for a random pair of satisfaction scores for a woman with her companion present compared with companion not present was 1.93 (95{\%} CI 1.30 to 2.81, P=0.001). Anxiety scores were decreased following the procedure (P=0.39)in both groups. Eighty-nine percent of women randomized to companion not present would have preferred to have a companion present (P <0.001)compared with only one with their companion present who would have preferred her companion to be not present (P=0.99). Conclusion: Maternal satisfaction can be improved with the presence of a companion in the labor and delivery room at the time of neuraxial catheter placement for labor analgesia.",
keywords = "Catheter placement, Companion presence, Labor analgesia, Neuraxial",
author = "E. Morell and Peralta, {Feyce Mabel} and Nicole Higgins and A. Suchar and P. Fitzgerald and McCarthy, {R. J.}",
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TY - JOUR

T1 - Effect of companion presence on maternal satisfaction during neuraxial catheter placement for labor analgesia

T2 - a randomized clinical trial

AU - Morell, E.

AU - Peralta, Feyce Mabel

AU - Higgins, Nicole

AU - Suchar, A.

AU - Fitzgerald, P.

AU - McCarthy, R. J.

PY - 2019/5/1

Y1 - 2019/5/1

N2 - Background: Neuraxial labor analgesia is frequently achieved after placing an epidural catheter under sterile conditions. There is no consensus on the risk versus benefit of allowing a parturient's companion to remain during the procedure. We sought to assess the effect of the presence of a companion on maternal satisfaction and anxiety during neuraxial catheter placement for labor analgesia. Methods: Healthy nulliparous parturients planning to receive neuraxial labor analgesia after admission to labor, and who had a companion with them at the time of interview, were randomized to having a companion present or not present in the labor and delivery room during neuraxial catheter placement. Participants completed questionnaires to assess maternal anxiety, pain catastrophizing and health literacy. Satisfaction was scored on 5-point Likert scale (1- highly dissatisfied, 2- dissatisfied, 3- neutral, 4- satisfied, 5- highly satisfied). Results: A total of 143 participants completed the study. The Wilcoxon–Mann–Whitney odds ratio for a random pair of satisfaction scores for a woman with her companion present compared with companion not present was 1.93 (95% CI 1.30 to 2.81, P=0.001). Anxiety scores were decreased following the procedure (P=0.39)in both groups. Eighty-nine percent of women randomized to companion not present would have preferred to have a companion present (P <0.001)compared with only one with their companion present who would have preferred her companion to be not present (P=0.99). Conclusion: Maternal satisfaction can be improved with the presence of a companion in the labor and delivery room at the time of neuraxial catheter placement for labor analgesia.

AB - Background: Neuraxial labor analgesia is frequently achieved after placing an epidural catheter under sterile conditions. There is no consensus on the risk versus benefit of allowing a parturient's companion to remain during the procedure. We sought to assess the effect of the presence of a companion on maternal satisfaction and anxiety during neuraxial catheter placement for labor analgesia. Methods: Healthy nulliparous parturients planning to receive neuraxial labor analgesia after admission to labor, and who had a companion with them at the time of interview, were randomized to having a companion present or not present in the labor and delivery room during neuraxial catheter placement. Participants completed questionnaires to assess maternal anxiety, pain catastrophizing and health literacy. Satisfaction was scored on 5-point Likert scale (1- highly dissatisfied, 2- dissatisfied, 3- neutral, 4- satisfied, 5- highly satisfied). Results: A total of 143 participants completed the study. The Wilcoxon–Mann–Whitney odds ratio for a random pair of satisfaction scores for a woman with her companion present compared with companion not present was 1.93 (95% CI 1.30 to 2.81, P=0.001). Anxiety scores were decreased following the procedure (P=0.39)in both groups. Eighty-nine percent of women randomized to companion not present would have preferred to have a companion present (P <0.001)compared with only one with their companion present who would have preferred her companion to be not present (P=0.99). Conclusion: Maternal satisfaction can be improved with the presence of a companion in the labor and delivery room at the time of neuraxial catheter placement for labor analgesia.

KW - Catheter placement

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KW - Labor analgesia

KW - Neuraxial

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JO - International Journal of Obstetric Anesthesia

JF - International Journal of Obstetric Anesthesia

SN - 0959-289X

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