Bayable Samuel Debas, Ahmed Seid Adem, Lema Girmay Fitiwi, Yaregal Melesse Debas
Department of Anesthesia, College of Medicine and Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia.
Department of Anesthesia, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Anesthesiol Res Pract. 2020 Oct 12;2020:8697651. doi: 10.1155/2020/8697651. eCollection 2020.
Spinal anesthesia is the most common anesthetic technique for cesarean delivery. Patient satisfaction is a subjective and complicated concept, involving physical, emotional, psychological, social, and cultural factors. Regular evaluation of maternal satisfaction related to anesthesia service is an important parameter to the required changes and expansion of high-quality care services. We aimed to assess maternal satisfaction and associated factors among parturients who underwent cesarean delivery under spinal anesthesia.
Institutional-based cross-sectional study was conducted from February to May 2019. A total of 383 parturients were enrolled to assess maternal satisfaction using a 5-point Likert scale. Both bivariable and multivariable logistic regression analyses were done. Variables of value ≤0.2 in the bivariable analysis were a candidate for multivariable logistic regression. A value <0.05 was considered as significantly associated with maternal satisfaction at 95% CI.
This study revealed that 315 (82.3%) of the parturients were satisfied. Single spinal prick attempts (AOR = 2.08, 95% CI = 1.05-4.11), successful spinal block (AOR = 7.17, 95% CI = 3.33-15.43), less incidence of postdural puncture headache (AOR = 2.36, 95% CI = 1.33-4.20), and prophylactic antiemetic use (AOR = 0.35, 95% CI = 0.19-0.66) were positively associated with maternal satisfaction.
The overall maternal satisfaction receiving spinal anesthesia was considerably low. Single spinal prink attempts, successful spinal block, and less incidence of postural puncture headache can increase maternal satisfaction. Therefore, effective perioperative management, skillful techniques, and using the small-gauge Quincke spinal needle (25-27 gauge) may increase the maternal satisfaction and quality of spinal anesthesia management.
脊髓麻醉是剖宫产最常用的麻醉技术。患者满意度是一个主观且复杂的概念，涉及身体、情感、心理、社会和文化因素。定期评估产妇对麻醉服务的满意度是高质量护理服务所需变革和扩展的重要参数。我们旨在评估接受脊髓麻醉下剖宫产的产妇的满意度及相关因素。
于2019年2月至5月进行了一项基于机构的横断面研究。共纳入383名产妇，使用5点李克特量表评估产妇满意度。进行了双变量和多变量逻辑回归分析。双变量分析中值≤0.2的变量是多变量逻辑回归的候选变量。值<0.05被认为在95%置信区间与产妇满意度显著相关。
本研究显示，315名（82.3%）产妇表示满意。单次脊髓穿刺尝试（调整后比值比[AOR]=2.08，95%置信区间[CI]=1.05 - 4.11）、成功的脊髓阻滞（AOR=7.17，95% CI=3.33 - 15.43）、硬膜穿刺后头痛发生率较低（AOR=2.36，95% CI=1.33 - 4.20）以及预防性使用止吐药（AOR=0.35，95% CI=0.19 - 0.66）与产妇满意度呈正相关。
接受脊髓麻醉的产妇总体满意度相当低。单次脊髓穿刺尝试、成功的脊髓阻滞以及姿势性穿刺头痛发生率较低可提高产妇满意度。因此，有效的围手术期管理、熟练的技术以及使用小号（25 - 27号）的昆克脊髓穿刺针可能会提高产妇满意度和脊髓麻醉管理质量。
