2012 Volume 13 Issue 1 Pages 31-35
Epidural anesthesia is widely performed and numerous benefits have been reported such as blood loss reduction, improved perioperative prognosis, requiring less analgesics and chronic postoperative pain prevention. On the other hand, infrequent crucial complications including epidural hematoma and epidural abscess could occur. In order to evaluate the effectiveness and complications of the epidural anesthesia, we reviewed 423 patients in our department who received epidural anesthesia with epidural catheter between July 2008 and May 2010. A template was designed to record detailed information about the epidural anesthesia of each patient such as performer's information, procedure date, puncture location and complications, and effectiveness was recorded on the electronic medical record. These data were then analyzed with Data Warehouse and three factors；the effectiveness, the incidence of dural puncture and the frequency of repeated puncture were evaluated as the quality indicators. We found that the anesthetic effect was lower and dural puncture or repeated puncture happened more frequently in the group of the young doctors who had less than two years experience in epidural anesthesia compared with the group of senior doctors with longer experience. This suggests that these three factors are useful as the quality indicators. The study indicates our record template would make it possible to compare the quality of the epidural anesthesia between the department of Obstetrics and Gynecology and the department of Anesthesia. In the future, by using these quality indicators between institutions, the safety and effectiveness of the epidural anesthesia could be objectively evaluated.
