Comparison of maternal satisfaction between epidural and spinal anesthesiafor elective Cesarean section

Purpose: Epidural anesthesia was a commonly used technique for elective Ces arean section. Recently, because of the availability of non-cutting spinal needles, many institutions have changed from epidural to spinal anesthesia. The purpose of this study was to compare maternal satisfaction between epi dural and spinal anesthesia for elective Cesarean section with a new satisf action tool. Methods: We studied healthy parturients in a randomized, double-blinded pil ot study in which patients were assigned to receive either epidural (n= 13) or spinal (n= 14) anesthesia for elective Cesarean section, Two and 24 hr postoperatively, patients completed a validated 22-point maternal satisfact ion questionnaire and a 10-cm visual analog score (VAS) for satisfaction. M aternal satisfaction scores were compared between groups. Results: There was no difference in demographics, complications or technica l failures between groups. Mean satisfaction scores on the questionnaire (0 - 154) at two and 24 hr were 130.23 +/- 11.36 and 129.54 +/- 16.70 for the epidural group and 116.92 +/- 18.47 and 115.92 +/- 15.71 for the spinal gro up (P = 0.04 and P = 0,03 respectively). No difference in VAS scores was no ted. The presence of minor side effects including pruritus contributed to t he lower satisfaction in the spinal group at 24 hr. Conclusion: This pilot study demonstrated higher maternal satisfaction with epidural than with spinal anesthesia for elective Cesarean section. This m ay be related to the increased side effects caused by neuraxial morphine. T he satisfaction questionnaire was able to elucidate differences not detecte d with a global VAS for satisfaction. Further study with a larger patient p opulation is required to confirm these data.