Acceptability of Health Care
Conditions
Keywords
Caesarean Section, Regional anaesthesia, Consent
Brief summary
Patient's safety and satisfaction are major concerns of anesthesiologists and obstetricians. According to evidence guidelines, and quality markers, regional anesthesia is preferred over general in obstetric surgery. Already a high level of anxiety is present in obstetric patients preoperatively.
Detailed description
Hospital anxiety is commonly encountered, and it is reported to be seen in 60%-80% of patients who undergo surgery. There are many causes of preoperative anxiety including fear of death due to anesthesia or surgical procedure and fear of preoperative or postoperative pain. Preoperative anxiety varies according to the patient's age, gender, educational status, history of previous operations, and medical status as well as the type of surgery and type of anesthesia. Patient's safety and satisfaction are major concerns of anesthesiologists and obstetricians. According to evidence guidelines, and quality markers, regional anesthesia is preferred over general in obstetric surgery. Already a high level of anxiety is present in obstetric patients preoperatively. The anxious patients tend to prefer general anesthesia (GA) for cesarean section (CS). The patient refusal is the main contraindication for applying spinal anesthesia (SA) during CS. The anxiety can be reduced variably by non-pharmacologic and pharmacologic methods including preoperative visit, information, and music, listening to Holy Quran recitation, hypnosis, nitrous oxide, and benzodiazepines. Intravenous sedation can control the anxiety in 90% of patients subjected to spinal procedures. While the evidence supports the benefits of procedural sedation for distressed, anxious pregnant women.
Interventions
BEHAVIORALPresence of Family member
The correlation between presence of the Family member and the consent for regional anaesthesia for Caesarean Section
Sponsors
Beni-Suef University
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
20 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
* primi gravida Patients aging 20\_40 years, ASA physical status I undergoing elective CS •
Exclusion criteria
High risk pregnancy eg: pre eclampsia Absolute contra indiction for SA eg: severe anaemia Emergent CS. Patients with previous exposure to anaesthesia ( spinal or general ). Patients with educational level more than high school.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Acceptance rate to spinal anaethesia during CS | Preoperative . | Questionnaire : The first decision for anesthesia, either spinal or general, will be recorded. Then, patients who refuse SA and prefer general anesthesia (GA) will be consulted again as regards SA with presence of close relative for comfortable spinal procedure. Their last choice is the second decision that determines the final type of anesthesia to be implemented. |
| Anxiety score by the visual analogue score (VAS). | Preoperative | the visual analog score (VAS) from 0- 10, where 10 is the maximum anxiety level |
| Satisfaction rating scale | 6 hours Postoperative | Scale ( 1 - 10 ) 1is the lowest satisfaction 10 is the best satisfaction |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| peripheral oxygen saturation (Spo2) | Preoperative | peripheral oxygen saturation (Spo2) |
| AGE | Preoperative | age per years |
| Height | Preoperative | Height per centimeter |
| WEIGHT | Preoperative | weight per kilograms |
| heart rate (beat/min) | Preoperative | heart rate (beat/min) |
| Mean arterial blood pressure MAP (mmHg) | Preoperative | Mean arterial blood pressure MAP (mmHg) |
Countries
Egypt
Outcome results
None listed