Preoperative Anxiety and Fear Regarding Type of Anesthesia (General vs. Spinal) and its Associated Factors in Women Undergoing Elective Cesarean Section
DOI:
https://doi.org/10.71147/795ry076Keywords:
Preoperative Anxiety, Elective Cesarean Section, Anesthesia Fears, State-Trait Anxiety,Abstract
Preoperative anxiety is a prevalent issue among women undergoing elective cesarean sections, particularly in developing countries. This anxiety is associated with unfavourable maternal and neonatal outcomes, including hemodynamic instability, increased analgesic needs, and lower APGAR scores. Anaesthesia, especially the choice between general and spinal, is a significant contributor to preoperative anxiety. Despite its high prevalence, preoperative anxiety is underrecognized and inadequately managed in many settings, including Libya. This study aims to assess preoperative anxiety levels and fears associated with general versus spinal anaesthesia in women undergoing elective cesarean sections. It also seeks to identify contributing factors, such as age, education, occupation, parity, and previous surgical experiences, to improve cesarean care quality.
Methods: A prospective cross-sectional study was conducted on 40 low-risk pregnant women scheduled for elective cesarean sections at Alwahda Hospital, Derna, from August to December 2024. Data were collected using a structured questionnaire comprising socio-demographic information, clinical factors, and the State-Trait Anxiety Inventory Scale (STAI). Results: Fear of not recovering from anaesthesia was the most common cause of anxiety (38.5%), followed by postoperative pain (23.1%). Bad obstetric history was associated with the highest mean anxiety score (9.92 ± 0.27). General anaesthesia was preferred by 62.5% of participants, while spinal anaesthesia was chosen by 37.5%. Multiparous women (85%) and those with previous obstetric surgeries (75%) exhibited higher anxiety levels. Participants with higher education (77.5%) and employment (57.5%) showed distinct anxiety patterns. Conclusion:
Preoperative anxiety in cesarean patients is significantly influenced by fears related to anaesthesia recovery, postoperative pain, and surgical complications. Tailored preoperative counselling and clear communication about anaesthesia options are essential for alleviating anxiety and improving maternal satisfaction. Future research should focus on intervention strategies to enhance perioperative care and patient outcomes
References
Abate SM, Chekol YA, Basu B. Global Prevalence and determinants of preoperative anxiety among surgical patients: A systematic review and Meta-analysis. Int J Surg Open. 2020; 25:6–16
Alma Soxhuku AM, et al. The role of maternal preoperative anxiety on hypotension after spinal anaesthesia in caesarean delivery. Int J Health Sci Res. 2016;6(4):2249–9571
Barros da Cunha AC, da Costa Gribel GP, Akerman LPF, Rocha AC. Pre-Anesthetic Consultation, Stress and Preoperative Anxiety in Risk Pregnant Women. Gynecology & Obstetrics Case report. 2018;04(1):63.
Baagil, H., & Gerbershagen, M. U. (2023). Preoperative Anxiety Impact on Anesthetic and Analgesic Use. MDPI. Retrieved from https://www.mdpi.com
.Bansal T, Joon A. A comparative study to assess preoperative anxiety in obstetric patients undergoing elective or emergency cesarean section. Anaesth Pain & Intensive Care 2017;21(1):25-308
caumo W, Schmidt AP, Schneider CN, Bergmann J, Iwamoto CW, Bandeira D, et al. Risk factors for preoperative anxiety in adults. Acta Anaesthesiol Scand. 2001;45(3):298–307
Dutta A. Post-spinal hypotension in parturients undergoing lower seg ment Caesarean section:‘preoperative anxiety’or ‘anti-hyperbaricity’.s. British J Anaesth. 2013;110(5):844–5.
Eberhart L, Aust H, Schuster M, Sturm T, Gehling M, Euteneuer F, et al. Preoperative anxiety in adults - a cross-sectional study on specific fears and risk factors. BMC Psychiatry. 2020;20(1):140
Hobson J, Slade P, Wrench I, Power L. Preoperative anxiety and postopera tive satisfaction in women undergoing elective caesarean section. Int J Obstet Anesth. 2006;15(1):18–23
Ozturk Inal Z, Gorkem U, Inal HA. Effects of preoperative anxiety on post cesarean delivery pain and analgesic consumption: general versus spinal anesthesia. J Matern Fetal Neonatal Med. 2020;33(2):191–7
Maheshwari D, Ismail S. Preoperative anxiety in patients selecting either general or regional anesthesia for elective cesarean section. J Anaesthe siol Clin Pharmacol. 2015;31(2):196.
Piščalkienė VBL. The expression of anxiety among women before cesar ean section and other operations: a comparative analysis. Education. 2012;5(24.8):29–4
Say L, Chou D, Gemmill A, Tunçalp Ö, Moller A-B, Daniels J, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Global Health. 2014;2(6):e323–33.
Schaal NK, Hepp P, Heil M, Wolf OT, Hagenbeck C, Fleisch M, et al. Perio perative anxiety and length of hospital stay after caesarean section - a cohort study. Eur J Obstet Gynecol Reprod Biol. 2020; 248:252–6
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