A Survey of the Reasons of Spinal Anesthesia Refusal in Pregnant Women in Alzahra Hospital during 2017

Farzi, F; Biazar, G; Omidi, S; Habibi, MR; Zohari Nobijari, T; Khosoosi Sani, M; Nematollahi, Godarz

A Survey of the Reasons of Spinal Anesthesia Refusal in Pregnant Women in Alzahra Hospital during 2017

Document Type : Original Article

Authors

F Farzi ¹

G Biazar ²

S Omidi ³

MR Habibi ³

T Zohari Nobijari ³

M Khosoosi Sani ⁴

Godarz Nematollahi ⁵

¹ Associate Professor of Anesthesia Department, Gilan University of Medical Sciences, Anesthesia Research Center, Al-Zahra Hospital (S)

² Assistant Professor of Anesthesia, Guilan University of Medical Sciences, Anesthesiology Research Center, Al-Zahra Hospital, Rasht, Iran

³ Assistant in Anesthesia Department, Gilan University of Medical Sciences, Anesthesia Research Center, Al-Zahra Hospital (S)

⁴ Assistant Professor, Department of Obstetrics and Gynecology, Guilan University of Medical Sciences, Health and Reproductive Research Center

⁵ General Physician, Guilan University of Medical Sciences, Anesthesia Research Center

Abstract

Introduction & Objective: Caesarean section is the most common method of termination of pregnancy. In this case, the choice of a low-risk, desirable, and affordable anesthetic technique for mother and baby is important. Based on valid studies, the preferred method for cesarean section is spinal anesthesia. However, the results of studies conducted in Iran have confirmed the high use of general anesthetic technique for performing cesarean section. Therefore, the aim of this study was to investigate the causes of non-acceptance of spinal episode in cesarean section by pregnant women. Materials & Methods: This descriptive cross-sectional study was performed on all pregnant women referred to al-Zahra hospital in Rasht, Iran, in 2017, for elective cesarean section. After obtaining informed consent from the subjects, a questionnaire consisting of demographic characteristics and questions about the reasons for not choosing the method of spinal anesthesia was conducted as a face-to-face interview with a trained technician. Finally, the data were analyzed using SPSS 21 software and appropriate statistical methods. Results: In this study, 386 pregnant women with a mean age of 30.09 ± 6.31 years and mean pregnancy rate of 2 ± 0.7 years were studied. Anxiety from back pain, seeing and hearing in the operating room needle stick pain" were the most common causes of non-acceptance of spinal anesthesia. Also, statistical significance was found between the education level of pregnant women and anxiety of the back pain" (P ˂ 0.0001), “seeing and hearing in the operating room" (P = 0.014), headache "(P = 0.009). A statistical relationship between anxiety about back pain", " anxiety for paralysis", " anxiety to see and hear in the operating room", ", headache, needle insertion pain" and pain during surgery"(P = 0.0001 in all cases). Also, there was a statistically significant correlation between the history of spinal anesthesia in pregnant women and "anxiety of back pain, paralysis and headache" was observed (P = 0.42, 0.027 and 0.03, respectively). Conclusions: Anxiety from back pain, seeing and hearing in the operating room and needle stick pain" were the most common causes of spinal anesthesia refusal. Enough attention and attempt to relief pregnant women in preoperative visits are recommended. In addition future multicenter studies involving private wards should be planned.

Keywords

Cesarean Section

Spinal Anesthesia

Refusal

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