The Role of Previous Spinal Anesthesia Experience in Anesthesia Preference for Cesarean Section

Spinal Anesthesia Experience and Anesthesia Preference

Abstract

Background: The choice of anesthesia in cesarean delivery is a crucial decision that affects maternal and neonatal outcomes. Beyond clinical indications, variables such as previous anesthetic experience, patient health literacy level, preoperative anxiety state, and the risk of adverse perioperative outcomes may significantly shape patient preferences. This study was designed to assess the impact of these factors on anesthetic modality selection among women scheduled for elective cesarean delivery.

Material and Methods: This single-center, cross-sectional survey included forty pregnant women within the eligible age range of 18–45 years who provided informed consent, all of whom had at least one previous spinal anesthesia experience. Data were collected using a structured questionnaire addressing demographic characteristics, prior anesthesia experiences, adverse effects, preoperative anxiety, and determinants of current preference. Statistical analyses employed chi-square and Fisher’s exact tests, odds ratios, and effect size measures.

Results: Spinal anesthesia was chosen by 80% of participants, while 20% preferred general anesthesia. A strong association was found between prior spinal anesthesia experience and current preference (p=0.003, Cramer’s V=0.517). Positive experiences strongly predicted repeated spinal preference (96%), whereas negative experiences were equally divided between spinal and general anesthesia. Adequate knowledge of spinal anesthesia was significantly associated with preference (p=0.043). Adverse effects were reported by 52.5% of patients, most commonly back pain (25%), nausea (20%), and vomiting (12.5%). Back pain (p=0.015), vomiting (p=0.003), and intraoperative pain (p=0.04) were significantly linked to avoidance of spinal anesthesia. Patients without prior side effects were nine times more likely to choose spinal anesthesia (OR=9.00; 95% CI: 0.989–81.9). Preoperative anxiety levels were also significantly associated with preference (p=0.006); severe anxiety increased general anesthesia preference, while low-to-moderate anxiety favored spinal anesthesia. Physician recommendation, pain control, and rapid postoperative recovery were rated as the most influential determinants.

Conclusion: Previous experiences, knowledge, adverse effects, and psychological state significantly influence anesthesia preferences in cesarean patients. Structured preoperative education, effective pain management, and strategies to minimize preventable side effects may enhance spinal anesthesia acceptance and improve maternal satisfaction.