A PROSPECTIVE STUDY OF MATERNAL SATISFACTION WITH SPINAL ANEASTHESIA FOR CAESAREAN DELIVERY IN A TERTIARY CARE HOSPITAL

Abstract

Introduction: Spinal anesthesia is a safe anesthetic technique for cesarean delivery which gained worldwide acceptance since the introduction to clinical practice. It has good quality of analgesia and avoids general anesthesia-related maternal morbidity and mortality, decreased risk of gastric aspiration, avoids exposure of anesthetic depressant drugs to the neonate, less incidence of deep venous thrombosis, and decreases blood loss during surgery. In addition, it has favorable effects on bonding the mother to the newborn. Materials and Methods: This is a historical, observational cross- sectional study of parturients who had epidural analgesia for labour in the year 2023. The routine practice in the institution is that the parturient is counselled by the anesthetists in the labour room, regarding the availability of labour analgesia services. Those who agree and consent for the same have it sited once they
are in active labour, in discussion with the obstetrician. The epidural is placed by conventional methods by a consultant or if a postgraduate student, under a consultant’s supervision. Titrated volumes of 0.1% ropivacaine with 10-20 mcg of fentanyl is used for the initial bolus followed by 0.1% ropivacaine plus 2 mcg/cc of Fentanyl as the continuous infusion.
Results: The details of 114 parturients who receive labour epidural during this period were entered and analysed. 96 (84.6%) were primigravida and 18 (15.4%) were multigravidas. 33 parturients (29.8%) had heard of labour analgesia before. 100 (90.1%) felt adequate information was provided by the anaesthesiologist regarding the epidural and 99 (88%) felt they had enough time to consent for the same. 97 (86.2%) felt they received the epidural ‘on time’. ‘On time’ was a subjective assessment by the parturient of promptness of initiation of epidural analgesia, once she requested the services. 73 (68.9%) said the infusion was given continuously through her labour. With regards to analgesia 95 (85.6%) felt their overall pain relief was adequate. Author assessed pain further in terms of when the pain was present and intensity of pain and found that 60% of parturients had no pain or the pain was present only sometimes. 25% had pain only during second stage. 60% of parturients had no pain or mild pain.
Conclusion: Patient satisfaction with regards to labour epidural is multifactorial. In patients opting for epidural analgesia, prompt initiation and effective pain relief is of utmost importance. Author need to concentrate on antenatal counselling of patients to disseminate appropriate and accurate information regarding labour analgesia and providing timely and quality service to the
patients.