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HOW MANY CASES DO WE NEED TO ACQUIRE AND MAINTAIN EPIDURAL CATHETERIZATION SKILL FOR OBSTETRICIAN IN OUR NEW LABOR ANALGESIA SYSTEM?
ESRA Academy. Irikoma S. Sep 8, 2016; 138274
Topic: Obstetric Population
Disclosure(s): There is no need to disclose actual financial value.
Dr. Shingo Irikoma
Dr. Shingo Irikoma

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Abstract
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Background and Aims:

A lack of anesthesiologists for the labor ward is a longstanding problem in Japan. But requests for labor analgesia by parturients have been increasing in Japan. To help spread the use of labor analgesia, we made a new system in which the trained obstetrician was responsible for epidural catheter insertion and epidural labor analgesia management with anesthesiologists’ support. We retrospectively researched the number of cases that obstetricians needed to acquire and maintain epidural catheterization skill in our institute.

Methods:

This study was approved by the Institutional Review Board in our hospital. Four obstetric residents were trained for 3 months each to acquire epidural catheterization skill with attending anesthesiologists from April in 2014 to March in 2015 in our hospital. After acquisition of epidural catheterization skill, they maintained that skill in the clinical setting. We counted the number of cases that obstetric residents practiced in training and in the clinical setting from our delivery databases.

Results:

Total anesthetic management cases for the 4 trainees were 236, 275,186 and 195, respectively. Cesarean section cases were 106, 94, 73 and 84, respectively. Median monthly cases of epidural catheterization in the clinical setting was 9 and range was 3 to 17 (total 42 months). There was only one unintentional dural puncture (0.24%) in this period.

Conclusions:

We established a novel labor analgesia system in a Japanese general hospital. We speculate that obstetricians can acquire the epidural catheterization skill with over 60 cases training and keep their skill with over 5 cases monthly.

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