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NZOZ Szpital na Siemiradzkiego
im. R. Czerwiakowskiego
31-137 Kraków
ul. Siemiradzkiego 1
tel. centrala (12) 634-22-22,
tel. przychodnia (12) 634-26-00
Kategoria: Nasz Szpital
Temat: A new quality in epidural analgesia
Ladies and gentlemen,

    The Na Siemiradzkiego Hospital specialises in obstetrics and, currently, also in gynaecology.  Since its origin (1985) it has been known as an obstetrical centre successfully implementing novel methods of perinatal care of mother and child. Those methods ensured the stay of the mother with her child directly after the delivery. Another innovative method was the presence of another person (most frequently the husband) accompanying the woman during the labour and delivery.   Those methods implied the necessity of continuous development and the improvement of the quality of perinatal care.  The effect of the steps taken was the appreciation of the hospital in the national ranking lists; for example, in the Childbirth with Dignity action the Na Siemiradzkiego Hospital was placed third in Poland.
    A very important element of the modern standard of perinatal care is pain relief which until recently was a great challenge for both professional and the organisational reasons.  The former required employing highly qualified anaesthesiologists.  There is no need to prove the necessity of high professional qualification.  It ensures the essential objective of medical care such as the safety of the mother and child as well as the adequate standard of the medical procedure. The latter requires the accessibility of the medical procedure. We were one of Poland's first hospitals that introduced round-the-clock availability of epidural analgesia of labour and delivery.
    There are several factors having the impact on the quality of epidural analgesia during labour and delivery.  Let us mention the most important ones, in particular those that will help you to understand the essence of the procedure.  One of the most important, or rather essential, objective of the procedure is analgesia, that is removal of pain.  On the other hand, analgesia should not impair the course of labour and delivery, especially its final stage, the so-called  second stage, that is the delivery of the baby, when the woman’s compliance and active pushing are very important.  The aim of this stage is physiological, or natural, delivery of the baby without having to use obstetrical instruments, that is applying the so-called instrumental delivery.
    We are proud to say that the introduction of the availability of epidural analgesia of the labour and delivery in our hospital has not resulted in the increase in the rate of instrumental delivery.   Currently, the number of women obtaining epidural analgesia amounts to 70%.  Another element is the comfort of the woman in labour in analgesia, especially the possibility to walk, use the toilet, etc.  Epidural analgesia administered in our hospital provides such a comfort due to the use of modern pharmaceutical agents.  After years of stagnation pharmaceutical companies started producing and marketing
a new generation of drugs used in analgesia.  Those drugs have a much broader spectrum of action between analgesia and impairment of motor functions. Those pharmaceutics, although considerably more expensive than those used so far, are associated with the fact the at present analgesia practically has no effect on the mechanism of labour and delivery, making it possible for the mother to joyfully experience the mystery of giving birth which is not disturbed by pain. Currently, in the Na Siemiradzkiego Hospital we solely use the new generation drugs for the analgesia of labour and delivery.

    Finally, there are a few words about the medical qualification for the epidural analgesia.  A very important issue for the normal course of labour and delivery is the right time of the induction of analgesia.  The qualification is made by the obstetrician-gynaecologist in the co-operation with the anaesthesiologist.
    In our hospital we use epidural analgesia for labour and delivery in two situations. 
The first situation involves medical indications and then the analgesia is free of charge.
The second situation involves the woman's desire and then the analgesia is paid for.   Some explanation is necessary here.  The scope of medical indications comprises many obstetrical situations, the most common of which is the impaired cervical dilation; however, we also use it with a very good effect in very young women in labour who quite often find it difficult to cope with pain and stress during labour and delivery.  Some medical conditions, eg.  asthma, may be medical indications for epidural analgesia of labour and delivery.  The final decision is always taken by both the anaesthesiologist and obstetrician-gynaecologist. 

    We would like to stress the fact that we provide equal medical care for all of our patients regardless of whether or not their hospitalisation is associated with additional non-standard costs of therapy!
    With great satisfaction and some dose of immodesty we can assure you that we are very successful in caring for your safe and comfortable labour and delivery.  Since true virtue is not afraid of criticism, we would like to ask you to share your opinions concerning the epidural analgesia and possible suggestions helping us to improve the pain-combating service in the Na Siemiradzkiego Hospital.

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