The Effect of Anaesthetic Method Used in The Elective Cesarean Section on Pain, Anxiety and Patient Satisfaction

Aim: The aim of this study was to primarily investigate the effects of selected anesthesia method on anxiety, patient satisfaction and pain level in elective caesarean section, and secondarily obtain information about quality of service.

Materials and Methods: The study was carried out as a prospective questionnaire in the Department of Anaesthesiology and Reanimation the Meram Medical Faculty Hospital of Necmettin Erbakan University between June 2017 and August 2017, on 160 volunteers aged between 18 and 45 years for whom elective cesarean section under General Anesthesia (GA) or Spinal Anesthesia (SA) was planned. Demographic data of the patients such as age, place of residence, education level, number of children, and cesarean experiences were recorded. In the preoperative and postoperative period, anxiety levels were measured by State-Trait Anxiety Inventory (STAI-D), pain levels were measured by Visual Analog Scale (VAS) scores and satisfaction levels were evaluated at postoperative 6th and 24th hours by (Quality of Recovery: QoR 40 T) questionnaire.

Results: There was no statistically significant difference between the patients' preoperative and postoperative anxiety scores and demographic data (p> 0.05). Patients with previous cesarean experience had lower preoperative anxiety levels (p <0.05). The STAI-D scores and the numbers of patients with anxiety in the GA and SA groups were similar (p> 0.05).Postoperative anxiety levels were significantly lower in both groups than in the preoperative period (p <0.05). VAS values of the SA group at the 6th and 24th hours were significantly higher than the group treated with GA.(p<0.05). The 24th hour VAS values of the SA group were higher than the VAS values at the 6th hour (p <0.05). In the GA group, VAS values at 24th hour were lower than the VAS values at 6th hour (p <0.05). The satisfaction levels of general anesthesia and spinal anesthesia were similar in the postoperative period (p> 0.05). Complaint of headache was high in SA group while complaint of sore throat was high in GA group(p<0.05). While there was no correlation between anxiety level, VAS values and satisfaction level (p> 0.05), there was a negative correlation between VAS values and pain parameters, which are the subgroup of satisfaction questionnaire, in both groups (p <0.05).

Conclusion: It is concluded that the preferred anesthesia method in elective cesarean section has no effect on anxiety and satisfaction, and the patient satisfaction level and service quality will be improved by providing effective analgesia by reviewing our postoperative pain algorithm.