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Maternal Satisfaction to Epidural and Spinal Anesthesia for Cesarean Section


Wacharin Sindhvananda MD*, Ruenreong Leelanukrom MD*,
Oraluxna Rodanant MD*, Pin Sriprajittichai MD*
*Department of Anesthesiology, Faculty of Medicine, Chulalongkorn University


Background and Objective : 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.
Material and Method : 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, which might be the confounding factors, were set up. Maternal satisfaction was evaluated
by the 11-item, qualified, self-administered questionnaire comprised of 4 common factors. The score of 0-10
Visual analog scale was used to access the degree of satisfaction. Trained personnel performed data collections
in the post-anesthesia care unit and ward. The means of the factor and total satisfaction scores were compared
between the two groups by Mann Whitney U test. A p-value < 0.05 considered significant.
Results : There was no statistical difference in the factor scores between the two groups. The total satisfactory
score was 89.48 + 9.31 and 90.03 + 11.26 in Group E and S respectively. No statistical difference of the total
satisfaction score was detected.
Conclusion : There was no difference in maternal satisfaction regarding to the techniques and the outcomes
between EA and SA .

Keyword : Satisfaction, Epidural, Spinal, Anesthesia, Cesarean section

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