An evaluation of regional anesthesia complications and patient satisfaction after cesarean section

Abstract

Background/Aim: In obstetric anesthesia, regional techniques are considered advantageous for maternal mortality and morbidity. Nevertheless, serious or less severe complications related to regional anesthesia may occur. This study aimed to determine the postoperative early complications and assess postoperative pain and satisfaction of the patients by conducting a postoperative survey among those operated with regional anesthesia on the day after cesarean section. Methods: All patients who underwent a cesarean section with regional anesthesia during the day within six months at our institution were considered for eligibility to participate in this cross-sectional study. On the day after the surgery, an anesthesiologist visited the patients and collected postoperative data, including demographic data and previous anesthesia experience, presence and intensity of the pain (current and from the operation until the postoperative visit), postoperative analgesia method, postoperative nausea, and vomiting (PONV), urinary catheterization, gas discharge, presence of backache, headache, shoulder pain, and initiation and the difficulties of breastfeeding. The patients were also questioned about their comfort during the operation, and their satisfaction with the anesthetic technique used. Results: A total of 729 patients participated in the survey. Postoperative pain was managed with paracetamol and non-steroidal anti-inflammatory drugs in 696 (95.5%) patients, PCEA in 25 (3.4%) patients and intravenous PCA in 8 (1.1%) patients. Six hundred and ninety-three (87.7%) patients had pain at the time of the visit and the mean VAS score of current pain intensity was 4.2 (1.7). Seven hundred and twenty-two (99.0%) patients had pain between the end of the operation until the postoperative visit and the mean VAS score of maximum pain intensity was 6.4 (2.0). The mean time until postoperative pain began was 3.7 (2.4) hours. Among all, 48.7% of the patients experienced backache, 36.9% had shoulder pain, 17.8% had postoperative nausea, 6.6% had postoperative vomiting, and 20.2% had a postpartum headache. Breastfeeding was not initiated until the first postoperative day in 87.5% of the patients and the mean time until the onset of breastfeeding was 1.9 (2.8) hours. The intraoperative comfort and satisfaction with the anesthesia method were rated as good/very good by 74.7% and 84.4% of our patients, respectively. Conclusion: Backache and shoulder pain are the most frequent minor complications in patients operated with regional anesthesia on the day after cesarean section. Determining and overcoming postoperative early complications is important for the satisfaction of patients after cesarean section.

Keywords

• Cesarean
• Regional anesthesia
• Postoperative complications
• Patient satisfaction

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