Caba F, Echevarría M, Gómez-Reja P, Calderón-Gavilán J, Martínez-Navas A, Merino-Grande S, Rodríguez-Rodríguez R
Servicio de Anestesiología y Reanimación, Hospital Universitario de Valme, Sevilla.
Rev Esp Anestesiol Reanim. 1998 May;45(5):172-8.
To compare satisfaction with local-regional and general anesthesia in women undergoing cesarean, the possible influence of time of evaluation and recall of the anesthesiologist.
Retrospective study performed in all women who delivered by cesarean in the 6 first months of 1997. The women were assigned to two groups according to type of anesthesia, local-regional or general. Their satisfaction with anesthesia was evaluated by questionnaire 48 to 72 hours after surgery and two weeks after release. Most items required discrete-point answers, including a satisfaction of a scale of 0 to 10. During the second interview we also evaluated satisfaction with the procedure and hospital in general, as well as recall of the anesthesiologist. Group homogeneity was based on demographic, sociocultural, obstetric and surgical variables.
In a context of high satisfaction with anesthesia, 189 (76%) of the 247 women receiving local-regional anesthesia gave high evaluations to the anesthesia (8.90 +/- 1.5; mean: 10), compared with 58 (24%) of those receiving general anesthesia (8 +/- 2; mean 8.5) (p = 0.001). Both groups were homogeneous except for the distribution of emergencies, which occurred more often in those receiving general anesthesia (p < 0.001). Women who had received local-regional anesthesia expressed greater willingness to repeat or recommend the technique (p < 0.001). The highest score in this group was from women receiving intradural anesthesia along with fentanyl for local anesthesia, with significant differences only in comparison to epidural anesthesia. The differences in responses between the first and second interview were scarce. The hospital received a lower evaluation than did either anesthesia or surgery (p < 0.001). The anesthesiologist, who was less well recognized than the obstetrician was remembered better among women receiving local-regional anesthesia (p = 0.008).
Local-regional anesthesia can improve levels of satisfaction over that of general anesthesia among women undergoing cesarean surgery, and contributes to maintaining recall of the anesthesiologist. These results may be related to the fact of being conscious during the birth of a child.
比较剖宫产妇女对局部区域麻醉和全身麻醉的满意度，以及评估时间和麻醉医生印象的可能影响。
对1997年头6个月内所有行剖宫产的妇女进行回顾性研究。根据麻醉类型将妇女分为两组，即局部区域麻醉组和全身麻醉组。在术后48至72小时以及出院后两周通过问卷调查评估她们对麻醉的满意度。大多数问题需要离散点回答，包括0至10分的满意度评分。在第二次访谈中，我们还评估了对手术过程和医院总体的满意度，以及对麻醉医生的印象。根据人口统计学、社会文化、产科和手术变量确保组间同质性。
在对麻醉满意度较高的情况下，接受局部区域麻醉的247名妇女中有189名（76%）对麻醉给予了高度评价（8.90±1.5；平均分：10），而接受全身麻醉的妇女中只有58名（24%）给予了高度评价（8±2；平均分8.5）（p = 0.001）。除了急诊分布情况外，两组在其他方面具有同质性，全身麻醉组的急诊发生率更高（p < 0.001）。接受局部区域麻醉的妇女表示更愿意再次选择或推荐该技术（p < 0.001）。该组中得分最高的是接受硬膜内麻醉联合芬太尼局部麻醉的妇女，与硬膜外麻醉相比，差异具有统计学意义。第一次和第二次访谈的回答差异不大。医院得到的评价低于麻醉或手术（p < 0.001）。与产科医生相比，麻醉医生的知名度较低，但在接受局部区域麻醉的妇女中，对麻醉医生的印象更好（p = 0.008）。
局部区域麻醉可提高剖宫产妇女对麻醉的满意度，高于全身麻醉，且有助于加深对麻醉医生的印象。这些结果可能与分娩过程中保持清醒有关。
