Morgan P J, Halpern S, Lam-McCulloch J
Department of Anesthesia, Mount Sinai Hospital, Toronto, Ontario, Canada.
Can J Anaesth. 2000 Oct;47(10):956-61. doi: 10.1007/BF03024865.
Epidural anesthesia was a commonly used technique for elective Cesarean section. Recently, because of the availability of non-cutting spinal needles, many institutions have changed from epidural to spinal anesthesia. The purpose of this study was to compare maternal satisfaction between epidural and spinal anesthesia for elective Cesarean section with a new satisfaction tool.
We studied healthy parturients in a randomized, double-blinded pilot study in which patients were assigned to receive either epidural (n = 13) or spinal (n = 14) anesthesia for elective Cesarean section. Two and 24 hr postoperatively, patients completed a validated 22-point maternal satisfaction questionnaire and a 10-cm visual analog score (VAS) for satisfaction. Maternal satisfaction scores were compared between groups.
There was no difference in demographics, complications or technical failures between groups. Mean satisfaction scores on the questionnaire (0-154) at two and 24 hr were 130.23 +/- 11.36 and 129.54 +/- 16.70 for the epidural group and 116.92 +/- 18.47 and 115.92 +/- 15.71 for the spinal group (P = 0.04 and P = 0.03 respectively). No difference in VAS scores was noted. The presence of minor side effects including pruritus contributed to the lower satisfaction in the spinal group at 24 hr.
This pilot study demonstrated higher maternal satisfaction with epidural than with spinal anesthesia for elective Cesarean section. This may be related to the increased side effects caused by neuraxial morphine. The satisfaction questionnaire was able to elucidate differences not detected with a global VAS for satisfaction. Further study with a larger patient population is required to confirm these data.
硬膜外麻醉是择期剖宫产常用的技术。近来，由于无切割脊麻针的应用，许多机构已从硬膜外麻醉改为脊麻。本研究的目的是使用一种新的满意度工具比较硬膜外麻醉与脊麻用于择期剖宫产时产妇的满意度。
我们在一项随机、双盲的前瞻性研究中研究了健康产妇，这些产妇被分配接受硬膜外麻醉（n = 13）或脊麻（n = 14）以进行择期剖宫产。术后2小时和24小时，患者完成一份经过验证的22分产妇满意度问卷和一个10厘米的视觉模拟评分（VAS）以评估满意度。比较两组产妇的满意度得分。
两组在人口统计学、并发症或技术失败方面无差异。硬膜外组术后2小时和24小时问卷的平均满意度得分（0 - 154）分别为130.23±11.36和129.54±16.70，脊麻组分别为116.92±18.47和115.92±15.71（分别P = 0.04和P = 0.03）。VAS评分无差异。包括瘙痒在内的轻微副作用的出现导致脊麻组在24小时时满意度较低。
这项前瞻性研究表明，择期剖宫产时产妇对硬膜外麻醉的满意度高于脊麻。这可能与鞘内注射吗啡引起的副作用增加有关。满意度问卷能够阐明总体VAS满意度未检测到的差异。需要对更多患者进行进一步研究以证实这些数据。
