Comparison of maternal satisfaction between epidural and spinal anesthesia for elective Cesarean section (original) (raw)
Related papers
Maternal satisfaction to epidural and spinal anesthesia for cesarean section
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2004
The differences between epidural (EA) and spinal (SA) anesthesia that can affect maternal satisfaction are the procedures, quality of anesthesia and postoperative events. Dominantly, postoperative events such as postdural puncture headache, pruritus and nausea or vomiting after spinal anesthesia are claimed to be its disadvantages. However, maternal satisfactory perception to theses two techniques has not been revealed. The authors' purpose was to compare maternal satisfaction regarding the techniques and their outcomes between EA and SA by the developed valid and reliable tool. Patients were randomly classified into two groups: epidural (Group E, n=56) and spinal (Group S, n = 58). Epidural and spinal anesthesia were administered with bupivacaine, 20 mL 0.5% with 1:200,000 epinephrine combined with two doses of 5 mg morphine and hyperbaric bupivacaine 2.2-2.4 mL 0.5% combined with 0.2 mg morphine respectively. Guidelines for treatment of intraoperative and postoperative events,...
Maternal Satisfaction of Spinal Anesthesia for Elective Cesarean Section in an Academic Hospital
Annals of Anesthesiology and Critical Care, 2017
Background: Currently, spinal anesthesia is an acceptable method for cesarean section (CS) throughout the world, since general anesthesia is associated with higher maternal morbidity and mortality rates. The current study was performed to survey different factors for maternal satisfaction of spinal anesthesia. Methods: This cross sectional study was performed on women who were candidates for elective CS at Dr. Shariati hospital. Informed consents were obtained from all the patients, and the risks and side effects of both spinal and general anesthesia were explained preoperatively. The mothers were free to choose the anesthetic technique. One day after the operation, all mothers were examined with respect to the variables. Results: A total of 84 women with the mean age of 30.7 ± 5.63 years and mean body mass index (BMI) of 31.2 ± 4.15 kg/m 2 were anesthetized through the spinal method. Overall, 28.6% of the subjects were distressed about perioperative awareness, while 40.5%, 29.8%, and 46.4% reported postoperative pain at the injection site, headache, and lumbar pain, respectively. Maternal satisfaction of the spinal method and willingness to choose this method again in future surgeries were 83.8% and 78.5%, respectively. Conclusions: Women undergoing CS are highly satisfied with spinal anesthesia, and the majority are likely to choose this method in the future. Factors decreasing satisfaction include inadequate preoperative explanations about the anesthesia method by the anesthesiologist, postoperative pain at the injection site, headache, and lumbar pain.
Medicine Science | International Medical Journal, 2019
Patient satisfaction is an important issue for patients overall health status and perception. Aim of the present study was to evaluate spinal anaesthesia related complications and other factors related with overall satisfaction level and compare satisfaction levels of patients' from 3 different regions of Turkey whom underwent caesarean section (CS) procedure under spinal anesthesia. Satisfaction levels of 285 patients underwent caesarean section under spinal anaesthesia were evaluated at postoperative 1st and 3rd days using a questionnaire form. Also perioperative complications and possible correlations between satisfaction levels were investigated. Patients' satisfaction levels were not affected by origins of patients. Most of the patients expressed satisfaction after spinal anaesthesia both at 1st and 3rd days postoperatively (82.1% vs 79.6% respectively). Postoperative pain at surgical site, backache and headache were top 3 factors related with decreased patient satisfaction. Also recurrent spinal puncture attempts, painful puncture attempts, inadequate analgesia, postoperative nausea and vomiting were correlated with decreased satisfaction levels (p<0.05). Spinal anaesthesia was significantly related with high satisfaction levels of patients underwent caesarean section. Controlling and managing possible complications and giving detailed information to patients may lead increased patient satisfaction levels.
To determine the level of the satisfaction in terms of intra-operative pain and postoperative nausea, vomiting, headache, backache among patients receiving spinal anesthesia for caesarean section.Methodology:Cross-sectional survey conducted in maternity and children hospital in Makkah from January 2014 to December 2015. A total of 200 pregnant patients undergoing caesarean section under spinal anesthesia were surveyed. A questionnaire was given to patients to score their satisfaction on a four-point visual analogue scale regarding:1-Pain during surgery, 2-Postoperative Nausea, and Vomiting (PONV), and 3-postoperative headache. The average of responses to questionnaire questions in each of the three areas was taken as the “FundamentalArea Score\"(FAS) and the average of these individual (FAS) scores was taken as the Patient Satisfaction score(PSS).Results: There was a high satisfaction score for PONV (90%); but satisfaction regarding intra-operative pain/discomfort, postoperative backache and headache has a lower satisfaction score plotted, as (88%, 87% and 55% respectively).Patient’s overall level of satisfaction with spinal anesthesia was 90%.Conclusion: Most of the patients in the study were satisfied with their experience with spinal anesthesia although there was a high frequency of postoperative backache.
Turkish Journal of Anesthesia and Reanimation, 2017
Obstetric anaesthesia aims to deliver a healthy baby as well as render a comfortable operation for the mother. This study compared general and spinal anaesthesia in terms of the quality of recovery and patient satisfaction in women undergoing emergency caesarean deliveries. Methods: In total, 100 patients were enrolled in this prospective, single-blind, cross-sectional clinical study. Patients were divided into spinal (n=50) and general (n=50) anaesthesia groups. The recovery score, pain and satisfaction were evaluated by Quality of Recovery Score (QoR-40), Visual Analogue Scale (VAS) and Numeric Rating Scale (NRS) at 24 hours postoperatively. Results: The total QoR-40 scores were significantly higher and the total operation time was longer in the spinal anaesthesia group (median score: 194.5 vs. 179.0, p<0.001 and mean±SD: 69.0±13.3 vs. 62.7±13.4 minutes, p=0.02, respectively). There was no significant difference in VAS and NRS scores between the groups. Conclusion: Both spinal anaesthesia and general anaesthesia have advantages and disadvantages in terms of emergency caesarean deliveries. Spinal anaesthesia speeds up the recovery time and enables the mother to return to normal life earlier, while general anaesthesia has a short initiation time and does not affect patient satisfaction.
ACTA MEDICA IRANICA
The severity of postoperative pain and hemodynamic changes during and post-cesarean section have a direct effect on the neonatal and maternal condition. This study aimed to compare pain severity, hemodynamic changes, and patient satisfaction following two anesthesia techniques in elective cesarean section. In this blinded study, 60 women who were candidate for cesarean section were allocated into two equal groups of general anesthesia (GA) and spinal anesthesia (SA). Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and O2 Saturation at pre cesarean (T0), the uterine incision time (T1), end of surgery (T2), 6h (T3), 12h (T4), and 24 hours post-cesarean (T5) were measured. A Visual Analog Scale assessed post-cesarean pain, 6, 12, and 24 hours post-cesarean. Gender, birth weight, first- and fifth- minutes’ apgar score was recorded in the checklists. The VAS score was significantly higher in the GA group at 6h, 12h, and 24 hours post-cesarean (P=0.014, P=0...
Anesthesiology Research and Practice
Objective. Satisfaction of mothers during caesarean section is an important indicator for measuring quality of obstetric anesthesia. This study aimed to determine mothers’ level of satisfaction and the predicting factors of dissatisfaction towards spinal anesthesia during caesarean section. Methods. Cross-sectional study design was utilized in Orotta Maternity Hospital (OMH) and Sembel Hospital from December 2017 to February 2018, in Asmara, Eritrea. Satisfaction of the mothers was measured using a pretested questionnaire. Bivariate and multivariate logistic regression were utilized to identify predictors of dissatisfaction using SPSS (Version 22.0). Results. Involvement of mothers in the choice of anesthesia (3.3%) and explanation about the stay at operating theater (10%) were the two least reported items. As per the subscale analysis, the lowest satisfaction was observed for the preoperative assessment (16.7%). Overall, 87.9% of the mothers were satisfied with the spinal anestheti...
Revista da Associação Médica Brasileira (English Edition), 2012
Objective: The objective of this study was to compare maternal satisfaction with childbirth according to whether or not combined spinal-epidural anesthesia (CSE) of pain relief was used during labor. Methods: A randomized, open clinical trial was performed with 70 pregnant women, 35 of whom received CSE anesthesia while 35 received only non-pharmacological forms of pain relief during labor. The variables evaluated were visual analogue scale (VAS) pain score, maternal satisfaction with the technique of pain relief used during childbirth and with delivery, the patient's intention to request the same technique in a subsequent delivery, and loss of control during delivery. Results: VAS pain score decreased significantly in patients receiving CSE during vaginal delivery. Furthermore, maternal satisfaction with the technique of pain relief and with delivery was higher in the CSE group, and around 97% of the patients would repeat the same technique at future deliveries compared to 82.4% of the women in the group using only non-pharmacological methods. With respect to the women's impressions of their control during delivery, approximately half the women in both groups felt that they had lost control at some point during the process. Conclusion: The use of CSE was associated with a significant reduction in VAS pain scores during delivery and with greater maternal satisfaction with the pain relief method and with the childbirth process.
Background: The main purpose of health care system should be adequate and appropriate treatment and health care management of the patients. Body of evidence revealed that maternal satisfaction and postoperative pain control were better in mothers who gave birth under spinal anesthesia than general anesthesia. However evidences are lacking locally, hence, this study was aimed to compare maternal satisfaction and postoperative pain severity in mothers who undergo caesarean section under general anesthesia and spinal anesthesia. Methods: After approval from institutional review Board (IRB), we studied 120 consecutive ASAI-II mothers who gave birth with cesarean section under spinal and General Anesthesia in Gandhi Memorial Hospital from august, 2013-July, 2014. Prospective effectiveness study design was employed. Patients were randomly allocated in two equal groups 60 patients each by lottery method after informed consent. Mothers with spinal Anesthesia group was preloaded with 1-1.5 litres of crystalloids before spinal Anesthesia and Spinal Anesthesia was given with 2-2.5ml of 0.5% bupivacaine in sitting position with strict aseptic technique. General Anesthesia was induced with rapid sequence induction with 3.5mg/kg of thiopental and 1-2mg/kg succinylcholine. General Anesthesia was maintained with 1-1.5v% halothane, 0.1mg/kg of vecronium and 1.5-2mg/kg of Pethdine. In the postoperative period, pain severity was measured at 2, 6 and 24hrs with Visual Analog Score (VAS) along with first analgesic request and satisfaction was assessed with Likert scale. Results: The total response rate of the study was 120 (100 %). The study revealed that types of anesthesia were independent predictor of maternal postoperative pain severity. Postoperative pain severity is greater than two times in Mothers who underwent caesarean section under general anesthesia than spinal anesthesia [AOR=2.4, 95% CI=1.03, 5.6]. Maternal satisfaction had no significant association with types of anesthesia by independent chi square test (P>0.078). The median time of first analgesic request in mothers underwent caesarean section under spinal anesthesia and general anesthesia was 93±4.2 and 80±3.9 minutes respectively. The mean intraoperative Systolic Blood pressure was lower in Anesthesia group as compared to general Anesthesia group unlike estimated blood loss which was higher in General Anesthesia group. Conclusion: The median time of first analgesic request was better in spinal analgesia compared to general anesthesia. However, Spinal anesthesia was associated with high incidence of hypotension. Appropriate perioperative patient care by anesthetist and provision of drugs for treatment of pain and hypotension were recommended.
South African Family Practice, 2018
Background: The most recommended type of anaesthesia by many obstetric guidelines for Caesarean section (CS) is spinal anaesthesia. This to achieve a higher level of pain and comfort control for the patient during and after CS. Little scientific research has assessed mothers' satisfaction with spinal anaesthesia. Methods: This was a cross-sectional study conducted at the maternity unit of Tembisa Hospital, South Africa in March 2014. Results: Overall satisfaction with spinal anaesthesia was 77.1%. The mean age (SD) was 27.9 (5.8) years. CS was mostly done as an emergency 63 (76.8%). The level of satisfaction varied greatly. There was a linear regression between age and answer scores regarding preoperative explanations (r = 0.2. R-squared = 0.05, p-value of 0.03. There was an association between preoperative explanations and gravidity (OR 13.1; CL 95%; CI 1.9-41.7; p = 0.0018). In perioperative time, elective CS was associated with verbal communication with the doctor administrating the spinal anaesthesia (OR 13.5; CL 95% CI 0.7-237.3; p = 0.0017). Pain at the injection site of lumbar puncture (OR 4; CL 95% CI 1.2-13; p = 0.025) and the atmosphere in the theatre (OR 4.1; CL 95% CI 1.1-15.5; p = 0.02) were determinant for future choice of spinal anaesthesia. Conclusion: Integrating pre-anaesthesia explanations in antenatal care and pre-anaesthesia counselling during labour and the use of adequate medication to reduce discomfort, pain and shivering may increase maternal satisfaction with spinal anaesthesia for CS.