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Patient Expectations and Preferences Regarding Anesthesia Care Surrounding Cesarean Delivery
Abstract Number: T1C-212
Abstract Type: Original Research
Introduction: Women’s expectations and preferences surrounding cesarean delivery (CD) is poorly elucidated (1). Carvalho et al. at Stanford University Hospital studied patient preferences for anesthesia-related outcomes after CD and determined that avoiding pain was most important relative to side-effects, and that paralysis was the most common anesthesia-related fear (2); however, most subjects in that study were Caucasian, had graduate degree education and had median annual household incomes of $50,000-100,000. The intention of this study was to determine these preferences in an urban, largely African-American population of more limited education and financial means. We hypothesized that this population might have dissimilar preferences and expectations regarding their anesthesia care during cesarean delivery.
Methods: Our population consisted of patients presenting for scheduled CD or induction of labor to our academic inner-city practice. We followed the same methodology of the Stanford University Hospital study (2). Patients were administered a preoperative survey regarding demographics and expectations and preferences and a briefer postoperative survey. Descriptive statistics were used to present data using n (%) for categorical data and median (interquartile range (IQR)) for continuous data.
Results: Of 93 patients offered the study, 75 consented to participate. Overall 73 completed a preoperative survey and 64 a postoperative survey. The study population consisted of mostly African-Americans with some college education, 58% of whom were married and 64% of whom had annual income less than $50,000 (Table 1). Pain during and after CD were ranked as least desirable outcomes and approximately 50% of patients expressed fear of paralysis as their principal concern with spinal/epidural anesthesia. Please see Table 1 for complete results.
Conclusions: Similar findings occurred despite the demographic differences between our patients and those in the previous study, perhaps indicating that fundamental concerns transcend demographic differences. Our results emphasize the importance of addressing paralysis during preoperative assessment to help ease patient concerns. Findings from this study should be used to improve anesthetic care and patient satisfaction by allowing the anesthesiologist to more closely meet patients’ expectations.
1. Pilnick et al. Social Science & Medicine 2011;72:1374-82
2. Carvalho et al. Anesth Analg 2005;101:1182-87