Assessing Maternal Satisfaction on Post-Dural Puncture Headache After Spinal Anesthesia for Cesarean Section in Tertiary Care Hospital of Peshawar
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Abstract
Background: Post-dural puncture headache is a clinically distressing complication of spinal anesthesia and may adversely affect maternal recovery, breastfeeding, newborn care, and satisfaction after cesarean delivery. Objective: To determine the frequency of post-dural puncture headache and evaluate its association with maternal satisfaction among women undergoing cesarean section under spinal anesthesia in tertiary care hospitals of Peshawar. Methods: A quantitative cross-sectional study was conducted at Northwest General Hospital and Research Centre and Khyber Teaching Hospital, Peshawar, over six months. A total of 170 mothers aged 18–40 years who underwent cesarean section under spinal anesthesia were recruited using non-probability convenience sampling. Data were collected using a structured questionnaire assessing demographic characteristics, clinical variables, PDPH occurrence, pain-relief satisfaction, and overall maternal satisfaction. Data were analyzed using SPSS version 28. Descriptive statistics, categorical association testing, and binary logistic regression were performed. Results: PDPH occurred in 31 mothers (18.2%), while 118 participants (69.4%) were satisfied with their anesthetic experience. PDPH was strongly associated with lower satisfaction, with 51.6% of affected mothers reporting dissatisfaction compared with 5.1% of mothers without PDPH. In analysis, absence of PDPH was the strongest predictor of satisfaction (AOR = 8.94, 95% CI: 3.72–21.46, p < 0.001), followed by elective cesarean section (AOR = 2.47, 95% CI: 1.19–5.12, p = 0.015) and multiparity (AOR = 2.11, 95% CI: 1.08–4.12, p = 0.029). Conclusion: Maternal satisfaction after spinal anesthesia for cesarean section was generally favorable, but PDPH was strongly associated with dissatisfaction. Preventive anesthesia practices, effective counseling, early postoperative screening, and prompt PDPH management may improve maternal experience in obstetric anesthesia care
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1. Apfelbaum JL, Hawkins JL, Agarkar M, Bucklin BA, Connis RT, Gambling DR, et al. Practice guidelines for obstetric anesthesia: an updated report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia and the Society for Obstetric Anesthesia and Perinatology. Anesthesiology. 2016;124(2):270-300. doi:10.1097/ALN.0000000000000935.
2. Rhee WJ, Chung CJ, Lim YH, Lee KH, Lee SC. Factors in patient dissatisfaction and refusal regarding spinal anesthesia. Korean J Anesthesiol. 2010;59(4):260-4. doi:10.4097/kjae.2010.59.4.260.
3. Smaoui M, Ayedi M, Derbel A, Barkia R, Akrout S, Kolsi K. Factors of patient dissatisfaction after spinal anesthesia for cesarean section. Eur J Anaesthesiol. 2012;29:164. doi:10.1097/00003643-201206001-00540.
4. Sadeghi M, Bayat R, Azimaraghi O, Saliminia A. Maternal satisfaction of spinal anesthesia for elective cesarean section in an academic hospital. Ann Anesthesiol Crit Care. 2017;2(2). doi:10.5812/aacc.62239.
5. Altiparmak B, Koseoglu SB. Assessment of satisfaction and anxiety levels of the patients who had cesarean section with general and spinal anesthesia. Int Med J. 2017;6(2):229-32.
6. Kathpalia SK. Early maternal feeding versus traditional delayed feeding after cesarean section: a pilot study. J Obstet Gynaecol India. 2017;67(3):178-82. doi:10.1007/s13224-016-0949-0.
7. Fesseha N, Getachew A, Hiluf M, Gebrehiwot Y, Bailey P. A national review of cesarean delivery in Ethiopia. Int J Gynaecol Obstet. 2011;115(1):106-11. doi:10.1016/j.ijgo.2011.07.011.
8. Broaddus BM, Chandrasekhar S. Informed consent in obstetric anesthesia. Anesth Analg. 2011;112(4):912-5. doi:10.1213/ANE.0b013e31820e777a.
9. Gebremedhn EG, Nagaratnam V. Assessment of patient satisfaction with the preoperative anesthetic evaluation. Patient Relat Outcome Meas. 2014;5:105-10. doi:10.2147/PROM.S66737.
10. Siddiqi R, Jafri SA. Maternal satisfaction after spinal anaesthesia for caesarean deliveries. J Coll Physicians Surg Pak. 2009;19(2):77-80.
11. Azari S, Sehaty F, Ebrahimi H. Satisfaction of women from cesarean section care services in public and private hospitals of Tabriz. Iran J Nurs Midwifery Res. 2013;18(6):435-8.
12. Hobson JA, Slade P, Wrench IJ, Power L. Preoperative anxiety and postoperative satisfaction in women undergoing elective caesarean section. Int J Obstet Anesth. 2006;15(1):18-23. doi:10.1016/j.ijoa.2005.05.008.
13. Makoko UM, Modiba LM, Nzaumvila DK. Satisfaction with spinal anaesthesia for Caesarean section at Tembisa Hospital, South Africa: a cross-sectional study. S Afr Fam Pract. 2018;60(2):39-47. doi:10.1080/20786190.2018.1531585.
14. Muneer MN, Malik S, Kumar N, Anwar S. Causes of refusal for regional anaesthesia in obstetrics patients. Pak J Surg. 2016;32(1):39-43.
15. Myles PS, Williams DL, Hendrata M, Anderson H, Weeks AM. Patient satisfaction after anaesthesia and surgery: results of a prospective survey of 10,811 patients. Br J Anaesth. 2000;84(1):6-10. doi:10.1093/oxfordjournals.bja.a013383.
16. Caljouw MAA, van Beuzekom M, Boer F. Patient satisfaction with perioperative care: development, validation, and application of a questionnaire. Br J Anaesth. 2008;100(5):637-44. doi:10.1093/bja/aen034.
17. Dharmalingam TK, Ahmad Zainuddin NA. Survey on maternal satisfaction in receiving spinal anaesthesia for caesarean section. Malays J Med Sci. 2013;20(3):51-4.
18. Ida M, Enomoto J, Yamamoto Y, Onodera H, Kawaguchi M. Factors associated with anesthetic satisfaction after cesarean delivery under neuraxial anesthesia. JA Clin Rep. 2018;4(1):66. doi:10.1186/s40981-018-0206-x.
19. Gil-Wey B, Savoldelli GL, Kern C, Haller G. Satisfaction maternelle de la prise en charge anesthésique durant l’accouchement: une étude de cohorte rétrospective. Can J Anaesth. 2011;58(10):936-43. doi:10.1007/s12630-011-9550-2.
20. Ahmed T, Assefa N, Demisie A, Kenay A. Levels of adult patients’ satisfaction with nursing care in selected public hospitals in Ethiopia. Int J Health Sci. 2014;8(4):371-9. doi:10.12816/0023994.
21. Argago TG, Hajito KW, Kitila SB. Clients satisfaction with family planning services and associated factors among family planning users in Hossana Town public health facilities, South Ethiopia: facility-based cross-sectional study. Int J Nurs Midwifery. 2015;7(5):74-83.
22. Gashaye KT, Tsegaye AT, Shiferaw G, Worku AG, Abebe SM. Client satisfaction with existing labor and delivery care and associated factors among mothers who gave birth in University of Gondar Teaching Hospital, Northwest Ethiopia: institution-based cross-sectional study. PLoS One. 2019;14(2):e0210693. doi:10.1371/journal.pone.0210693.