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Comparison of maternal satisfaction between epidural and spinal anesthesia for elective Cesarean section

Canadian Journal of Anesthesia volume 47, Article number: 956 (2000) Cite this article

Abstract

Purpose: Epidural anesthesia was a commonly used technique for elective Cesarean section. Recently, because of the availability of non-cutting spinal needles, many institutions have changed from epidural to spinal anesthesia. The purpose of this study was to compare maternal satisfaction between epidural and spinal anesthesia for elective Cesarean section with a new satisfaction tool.

Methods: We studied healthy parturients in a randomized, double-blinded pilot study in which patients were assigned to receive either epidural (n=13) or spinal (n=14) anesthesia for elective Cesarean section. Two and 24 hr postoperatively, patients completed a validated 22-point maternal satisfaction questionnaire and a 10-cm visual analog score (VAS) for satisfaction. Maternal satisfaction scores were compared between groups.

Results: There was no difference in demographics, complications or technical failures between groups. Mean satisfaction scores on the questionnaire (0–154) at two and 24 hr were 130.23±11.36 and 129.54±16.70 for the epidural group and 116.92±18.47 and 115.92±15.71 for the spinal group (P=0.04 andP=0.03 respectively). No difference in VAS scores was noted. The presence of minor side effects including pruritus contributed to the lower satisfaction in the spinal group at 24 hr.

Conclusion: This pilot study demonstrated higher maternal satisfaction with epidural than with spinal anesthesia for elective Cesarean section. This may be related to the increased side effects caused by neuraxial morphine. The satisfaction questionnaire was able to elucidate differences not detected with a global VAS for satisfaction. Further study with a larger patient population is required to confirm these data.

Résumé

Objectif: L’anesthésie péridurale était une technique couramment utilisée pour la césarienne. Récemment, avec l’arrivée des aiguilles mousses, de nombreuses institutions ont préféré la rachianesthésie. La présente étude voulait comparer, avec un nouvel outil de mesure, le degré de satisfaction de la mère pendant la césarienne sous anesthésie péridurale ou rachidienne.

Méthode: Des parturientes en bonne santé ont fait l’objet d’une étude pilote randomisée et à double insu. Elles ont reçu soit une anesthésie péridurale (n=13), soit une rachianesthésie (n=14), pendant une césarienne planifiée. Après l’opération, 2 h et 24 h, la satisfaction des patientes a été évaluée à l’aide d’un questionnaire validé de 22 items et d’une échelle visuelle analogique (EVA) de 10 cm. On a comparé les scores de satisfaction maternelle.

Résultats: Les données démographiques, complications ou défaillances techniques étaient similaires dans les deux groupes. Les scores moyens au questioonnaire sur la satisfaction (0–154), 2 h et 24 h après l’intervention, ont été de 130,23±11,36 et 129,54±16,70 avec l’anesthésie péridurale, et de 116,92±18,47 et 115,92±15,71 avec la rachianesthésie (P=0,04 etP=0,03 respectivement). Aucune différence de score à l’EVA n’a été notée. Des effets secondaires mineurs, comme le prurit, ont fait baisser le taux de satisfaction 24 h après la rachianesthésie.

Conclusion: Cette étude pilote a démontré que les mères préfèrent l’anesthésie péridurale à la rachianesthésie pendant la césarienne. Ce qui peut dépendre d’effets secondaires plus importants causés par la morphine médullaire. Le questionnaire sur la satisfaction a mis en évidence des différences non détectées avec l’EVA globale sur le même sujet. Une étude supplémentaire comprenant un grand nombre de patientes demeure nécessaire pour confirmer ces données.

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Affiliations

  1. From the Department of Anesthesia, Mount Sinal Hospital, Canada

    Pamela J. Morgan MD CCFP FRCPC

  2. Sunnybrook and Women’s College Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada

    Stephen Halpern MD FRCPC MSc & Jenny Lam-McCulloch BSc MSc

Authors
  1. Pamela J. Morgan MD CCFP FRCPC
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  2. Stephen Halpern MD FRCPC MSc
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  3. Jenny Lam-McCulloch BSc MSc
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Corresponding author

Correspondence to Pamela J. Morgan MD CCFP FRCPC.

Additional information

Supported by a research scholarship from the Maternal, Infant and Reproductive Health Research Unit (MIRU) at the University of Toronto.

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Morgan, P.J., Halpern, S. & Lam-McCulloch, J. Comparison of maternal satisfaction between epidural and spinal anesthesia for elective Cesarean section. Can J Anesth 47, 956 (2000). https://doi.org/10.1007/BF03024865

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  • DOI: https://doi.org/10.1007/BF03024865

Keywords

  • Spinal Anesthesia
  • Epidural Anesthesia
  • Ephedrine
  • Elective Cesarean Section
  • Epidural Morphine