Factors influencing patient preference towards general and regional anesthesia in patients presented for elective cesarean section

Paper Details

Research Paper 01/04/2020
Views (281) Download (17)

Factors influencing patient preference towards general and regional anesthesia in patients presented for elective cesarean section

Said Khitab Shah, Shah Faisal, Muhammad Tayyeb, Ayesha Jehad, Irfan Ullah, Muhammad Ajmal, Bashir Ul Haq, Mukhtair Ahmad, Ayub Said
Int. J. Biosci.16( 4), 481-486, April 2020.
Certificate: IJB 2020 [Generate Certificate]


Out of all the common surgeries performed in women, Caesarean Section is one of them. In this procedure, General Anesthesia as well as Regional Anesthesia is given. But GA usage has been reduced due to risk of maternal mortality. Thus Spinal Anesthesia is the better alternative in 80 to 90% of Caesarean Sections performed. This cross sectional study was carried out from March 19-2018 up to April 19- 2018 in Obstetrics Unit of Lady Reading Hospital Peshawar and Rehman Medical Institute Peshawar. This study included 56 patients. Ages were between 18 and 42 years. The mean age was 30 years ±0.639. 30.4% patients’ previous CS was performed under RA while GA was given in 35.7% patients. Patients good experience with RA (19.6%, N=11) is the main reason they prefer RA. Caesarean Section is the most trivial surgical procedure performed in Obstetrics patients. 85.7% patients are aware of the techniques of anesthesia used in CS. This coincides with the results of studies completed in Karachi, Hong Kong and United Kingdom which are 82.4%, 70% and 78% respectively. 32.1% of patients had selected GA over RA. But after properly educating them, they now prefer RA. From this we can see importance of effective preoperative information which has increase preference toward RA. Similar results had been given by other studies Patients’ choice of anesthesia is based on their previous experiences rather than the risk or benefits of each technique. Educating such patients enhances their preference of RA.


Afolabi BB, Lesi FE. 2012. Regional versus general anaesthesia for caesarean section. Cochrane database of systematic reviews (10).

Ahmad I, Afshan G. 2011. Knowledge and attitudes of Pakistani women towards anaesthesia techniques for caesarean section. Journal of the Pakistan Medical Association 61(4), 359.

Algert CS, Bowen JR, Giles WB, Knoblanche GE, Lain SJ, Roberts CL. 2009. Regional block versus general anaesthesia for caesarean section and neonatal outcomes: a population-based study. BMC medicine 7(1), 20.

Bjørnestad E, Iversen OE, Raeder J. 2004. The impact of increasing the use of regional anaesthesia for emergency caesarean section. European journal of anaesthesiology 21(10), 776-780.

Colvin JR, Peden C (Eds.). 2012. Raising the standard: a compendium of audit recipes for continuous quality improvement in anaesthesia. Royal College of Anaesthetists.

Fakherpour A, Ghaem H, Fattahi Z, Zaree S. 2018. Maternal and anaesthesia-related risk factors and incidence of spinal anaesthesia-induced hypotension in elective caesarean section: A multinomial logistic regression. Indian journal of anaesthesia 62(1), 36.

Halpern SH, Soliman A, Yee J, Angle P, Ioscovich A. 2009. Conversion of epidural labour analgesia to anaesthesia for Caesarean section: a prospective study of the incidence and determinants of failure. British journal of anaesthesia 102(2), 240-243.

Ismail S, Shafiq F, Malik A. 2012. Technique of anaesthesia for different grades of caesarean section: A cross-sectional study. Journal of the Pakistan Medical Association 62(4), 363.

Jemal B, Alemu M. 2016. Perception, Knowledge and Attitude of Developing Country Pregnant Mothers about Anesthesia for Cesarean Section. Universal Journal of Medical Science 4(1), 31-37.

Johnson CT, Johnson TR, Adanu RM. 2015. Obstetric surgery. In Essential Surgery: Disease Control Priorities, Third Edition (Volume 1). The International Bank for Reconstruction and Development/The World Bank.

Johnson D, Truman C. 2002. Hospital practice more than specialty influences the choice of regional or general anesthesia for Cesarean section. Canadian Journal of Anesthesia 49(9), 954-957.

Kadri IA, Haider G, Memon I, Memon W. 2014. Awareness of patients regarding anesthesia. The Professional Medical Journal 21(04), 782-787.

Karaaslan P, Aydın C, Aksu T. 2014. Factors influencing the preference of regional anaesthesia in the obstetric population: A survey study. Turkish journal of anaesthesiology and reanimation 42(4), 176.

Montoya Botero BH, Oliveros Wilches CI, Moreno Martínez DA. 2009. Managing hypotension induced by spinal anesthesia for caesarean section. Revista Colombiana de Anestesiología 37(2), 131-140.

Ni HF, Liu HY, Zhang J, Peng K, Ji FH. 2017. Crystalloid Coload reduced the incidence of hypotension in spinal anesthesia for cesarean delivery, when compared to crystalloid preload: a meta-analysis. BioMed research international 2017.

Okafor UV, Ezegwui HU, Ekwazi K. 2009. Trends of different forms of anaesthesia for caesarean section in South-eastern Nigeria. Journal of Obstetrics and Gynaecology 29(5), 392-395.

Pregnancy and birth: Cesarean sections: What are the pros and cons of regional and general anesthetics? (2018, March 22). Nih.Gov; Institute for Quality and Efficiency in Health Care (IQWiG). https://www.ncbi.nlm.nih.gov/books/NBK279566/

Saunders TA, Stein DJ, Dilger JP. 2006. Informed consent for labor epidurals: a survey of Society for Obstetric Anesthesia and Perinatology anesthesiologists from the United States. International journal of obstetric anesthesia 15(2), 98-103.

Schmidt AP, Auler JOC. 2012. Evidence-based obstetrics anesthesia.An update on anesthesia for Caesarean delivery. In: Salim R, editor. Cesarean delivery. Rijeka: In Tech p. 69-92.

Spielman FJ, Corke BC. 1985. Advantages and disadvantages of regional anesthesia for cesarean section. A review. The Journal of reproductive medicine 30(11), 832-840.

To WW. 2007. A questionnaire survey on patients’ attitudes towards epidural analgesia in labour. Hong Kong Medical Journal 13(3), 208.