Effect of Structured Counselling on Women's Ch< oice of Anaesthesia for Elective Repeat Caesarean Section (ERCS) At Abbasi Shaheed Hospital: A Cross Sectional Comparative Survey
Abstract:Objective: To evaluate the effect of structured counselling on women's choice of obstetrical anaesthesia for elective caesarean section.
Methods: This was a cross-sectional comparative survey conducted at department of gynaecology (unit II), Abbasi Shaheed Hospital, Karachi, from 1st January, 2017 to 30th June, 2017. The study included 250 pregnant women at term ( ³37 weeks) with a prior caesarean section, planned for elective caesarean having no contraindications to spinal or general anaesthesia. Exclud… Show more
Background
Parturients are highly anxious preoperatively. The worries of spinal anesthesia may preclude its acceptance despite being recommended. Procedural sedation is not a routine during regional blocks, but it is sensible that anesthesiologists should provide their blocks comfortably. The proposal is that implementing the propofol procedural sedation (PPS) may increase the acceptance rate of spinal anesthesia for cesarean section.
Methods
In this prospective observational study, the patients who refused spinal anesthesia primarily were interrogated to implement PPS for painless comfortable spinal anesthesia. Their acceptance rate was the primary outcome. In the sitting position, propofol 0.7 mg/kg and 20 mg increments were used as required. Patients were well supported and monitored. Data were compared by Mann-Whitney, chi-square, Fisher’s exact, and Friedman’s ANOVA tests as appropriate.
Results
The acceptance rate of spinal anesthesia increased from 17 to 93%. During PPS, the mean values of minimal mean blood pressure were not significantly decreased, while the mean values of the heart rate slightly increased. The minimal values of oxygen saturation showed no significant reduction compared to the basal values. Patients expressed a marked relief of anxiety and high satisfaction.
Conclusion
The use of propofol procedural sedation was effective in increasing the acceptance rate of spinal anesthesia during CS with safety and high patient’s satisfaction.
Background
Parturients are highly anxious preoperatively. The worries of spinal anesthesia may preclude its acceptance despite being recommended. Procedural sedation is not a routine during regional blocks, but it is sensible that anesthesiologists should provide their blocks comfortably. The proposal is that implementing the propofol procedural sedation (PPS) may increase the acceptance rate of spinal anesthesia for cesarean section.
Methods
In this prospective observational study, the patients who refused spinal anesthesia primarily were interrogated to implement PPS for painless comfortable spinal anesthesia. Their acceptance rate was the primary outcome. In the sitting position, propofol 0.7 mg/kg and 20 mg increments were used as required. Patients were well supported and monitored. Data were compared by Mann-Whitney, chi-square, Fisher’s exact, and Friedman’s ANOVA tests as appropriate.
Results
The acceptance rate of spinal anesthesia increased from 17 to 93%. During PPS, the mean values of minimal mean blood pressure were not significantly decreased, while the mean values of the heart rate slightly increased. The minimal values of oxygen saturation showed no significant reduction compared to the basal values. Patients expressed a marked relief of anxiety and high satisfaction.
Conclusion
The use of propofol procedural sedation was effective in increasing the acceptance rate of spinal anesthesia during CS with safety and high patient’s satisfaction.
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