The degree of obesity that contribute to the failure epidural anaesthesia for parturient mothers undergoing lower segment caesarian section
The degree of obesity that contributing to failure epidural anaesthesia was the main focused in this study. The target samples were parturient mothers undergoing lower segment caesarian section either for an emergency or elective. Parturient mothers chosen as samples were analysed for anthropometry....
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| Format: | Thesis |
| Language: | English English |
| Published: |
2013
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| Subjects: | |
| Online Access: | https://eprints.ums.edu.my/id/eprint/41822/1/24%20PAGES.pdf https://eprints.ums.edu.my/id/eprint/41822/2/FULLTEXT.pdf |
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| Summary: | The degree of obesity that contributing to failure epidural anaesthesia was the main focused in this study. The target samples were parturient mothers undergoing lower segment caesarian section either for an emergency or elective. Parturient mothers chosen as samples were analysed for anthropometry. Sampling of the study was done through universal convenience method whereby parturient mother planed for epidural anaesthesia or epidural anaesthesia converted to general anaesthesia included into this study. Samples were categorized into two groups non obese and obese. Samples strength were based on the Survey System with confidence level at 95.0% and confidence interval at 5.0%. The researcher observed the epidural anaesthesia procedure carried out by anaesthetist for the purpose of obtaining data in operating theatre. Research forms used in this data collection were divided into five sections. The first section (section A) was about the demographic background of parturient mothers. The second section (Section B) focused on the procedure and technique while the third section (Section C) involved with drugs used for epidural anaesthesia procedure. The fourth section (Section D) was pertaining to problems during attempt in epidural anesthesia procedure. The last section (Section E) was on sensory blocked level measured using pin-prick test and motor block evaluation based on Bromage Scale. Samples of parturient mothers planned for Lower Segment Caesarian Section either successful or failed epidural anaesthesia included in this study were considered as inclusion criteria. Samples of parturient mothers planned for Lower Segment Caesarian Section but ended with vaginal delivery were considered as exclusion criteria. Hypothesis of the study, there was a significant different in the occurrence of failure epidural anaesthesia between the degree of body mass index BMI group for parturient mothers undergoing lower segment caesarian section LSCS. Based on descriptive analysis, Generally, respondents profiles related to demographic and ethnographic were considered not factors for the failure of epidural anaesthesia except age became the positive association based on Chi Square P = 0.02 .The Visual Analogue Pain Score VAPS 1 (84.8% within non obese group). The percentage of pain rating scale VAPS 1 slightly higher in obese group (85.0% within obese group). With this aspect, some differences in pain rating scale VAPS 1 when P < 0.05 (P = 0.00) from Pearson Chi Square. The incident of general anesthesia conversion was much higher when parturient mothers experienced 0.0 – 33.0% the degree of block (Bromage Scale) for both right and left lower limbs. It was also been observed that between 66.0 % – 100 % degree of block (Bromage Scale) still got chance to be converted into general anesthesia. Epidural anesthesia was used successfully for LSCS surgery in all 33 cases of non obese parturient mothers and 114 of 120 obese parturient mothers. Mean Bromage score based on four criteria degree of right lower limb for obese group (1.94 ± 0.124) much higher than non obese group (1.85 ± 0.222). Similarly mean Bromage score based on four criteria degree of left limb for obese group (2.00 ± 0.124) much higher than non obese group (1.85 ± 0.222). Overall, there was no significant different in term of anaesthesia failure rate among the category of BMI as well as between non obese and obese parturient mothers undergoing the Lower Segment Caesarian Section LSCS surgery as tested with Chi Square two tailed with P = 0.38 (P > 0.05). Hence, epidural anaesthesia is still good perspective for obese parturient mothers even though pre obese category of Body Mass Index proven of epidural anaesthesia failure. The overall failure rate of epidural anaesthesia in this research was 3.9% and in looking to this, epidural anaesthesia became a good prospective to be practiced for non obese and obese parturient mothers undergoing LSCS. |
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