Study of maternal satisfaction and associated factors toward spinal anesthesia for cesarean section: a cross-sectional study

doi:10.21203/rs.3.rs-3964890/v1

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Study of maternal satisfaction and associated factors toward spinal anesthesia for cesarean section: a cross-sectional study

https://doi.org/10.21203/rs.3.rs-3964890/v1

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Background

Maternal satisfaction during a cesarean section is an important indicator for measuring the quality of obstetric anesthesia. This study aimed to determine the level of mothers’ satisfaction with spinal anesthesia for a cesarean section.

Methods

A cross-sectional study, conducted on a sample of the Syrian community, including 120 participants, between 5/29/2023 and 10/31/2023. A questionnaire prepared by the supervisor was used. The internal consistency measure was very good (Cronbach-α = 0.946), and included questions about (age, educational level, obstetric history, medical and surgical history...) and a measure of maternal satisfaction with spinal anesthesia (It consists of six topics)

Results

The ages of participants ranged between 21–50 years, with an average age of 30.25. The education level of the largest percentage of participants was university (71.7%). All participants were married (100%). More than half of the participants were parous (65.8%). Only (25%) of the participants experienced pain during surgery. Only (20%) of them suffered from nausea and vomiting postoperatively. Their satisfaction with spinal anesthesia for caesarean section was 60%. In general, the satisfaction rate regarding future spinal anesthesia procedure was (49.3%).

Conclusion

Overall maternal satisfaction can be considered acceptable, but preoperative evaluation and postoperative care are somewhat low. The relationship between the anesthesiologist and the patient and the doctor's attention during the surgical procedure were good. Explaining the benefits and risks of anesthesia techniques to patients, as well as taking their opinion into account, is very important when determining the type of anesthesia.

Anesthesiology & Pain Medicine

spinal anesthesia

cesarean section

maternal satisfaction

Spinal anesthesia (SA) is a safe anesthesia technique for cesarean section (CS) that has gained global acceptance since its introduction into clinical practice [1, 2]. It has good analgesic quality, avoids maternal morbidity and mortality associated with general anesthesia, reduces the risk of infectious aspiration, avoids exposure to neonatal anesthetic drugs, reduces the incidence of deep venous thrombosis, and reduces blood loss during surgery [2–3]. In addition, it has positive effects on the mother’s attachment to the newborn [4].

Satisfaction with service provision is one of the main determinants of the quality of care in a hospital [6]. Globally, of the 213 million births, caesarean sections accounted for 18.5 million, indicating a high incidence [7]. In the last two decades, the rate of caesarean sections has tripled [8].

During preoperative anesthesia evaluation, it is important to explain the procedure, side effects, and potential complications of spinal anesthesia for labor and obtain informed consent, and this process may improve information retention and increase maternal satisfaction [9–11]. In addition, emotional support before spinal anesthesia for cesarean delivery helps reduce preoperative anxiety and increase maternal satisfaction [12, 13].

Keeping the mother awake, minimal fetal depression, small drug dose, low failure rate, rapid onset, and simplicity of technique make spinal anesthesia more common than general anesthesia for cesarean sections [14]. Furthermore, better neonatal outcomes have been reported for newborns of mothers who underwent regional anesthesia compared to general anesthesia [15].

Since 2001, more caesarean sections have been performed under spinal anesthesia [16], but some countries have reported higher rates of general anesthesia for caesarean sections [8]. Likewise, spinal anesthesia for caesarean section has become the routine and preferred method among anesthesiologists in Syria. Studies conducted in Australia and Kenya on obstetric surgery revealed that mothers being illiterate, multiparous, and having no comorbidities significantly increased their satisfaction [17, 18]. In addition, a similar study conducted in Canada showed that being young, good coordination, and absence of complications were the most influential factors in determining satisfaction with childbirth [19].

Previous studies on maternal satisfaction after cesarean section for cesarean delivery showed that paresthesias, multiple puncture attempts, needle prick pain, intraoperative hypotension, failure of anesthesia, use of prophylactic antiemetics, vomiting intraoperatively, inadequate analgesia, and headache were major obstacles. In front of maternal satisfaction after spinal anesthesia [2, 4, 5, 11, 20, 21].

Anesthesia may be performed by so-called “anesthesia technicians” in Syria, due to the small number of anesthesiologists. As the rate of caesarean sections increased, the demand for spinal anesthesia increased. Therefore, ensuring the quality of obstetric anesthesia becomes the vital concern that the anesthesiologist needs to focus on.

Although the majority of anesthesiologists prefer spinal anesthesia, it was very important to know whether the number of patients appreciated it or not. Evaluating maternal satisfaction with spinal anesthesia during cesarean section can be an important aspect of measuring the quality of anesthesia care.

Identifying factors that enhance or decrease maternal satisfaction will assist in the development of protocols in obstetric anesthesia services. Research studies conducted on maternal satisfaction with spinal anesthesia in cesarean section patients have revealed differences.

Some developed countries reported a high rate of satisfaction [22], while maternal satisfaction in developing countries, such as Ethiopia, was slightly lower, at 62% [23].

Aim of the study:

Mothers' satisfaction during a cesarean section is an important indicator for measuring the quality of obstetric anesthesia. This study aimed to determine the level of mothers' satisfaction with spinal anesthesia for a cesarean section.

study design:

A cross-sectional study, conducted on a sample of Syrian society, including 120 participants, in the period between 5/29/2023 and 10/31/2023.

Sample collection tool:

The internal consistency measure was very good (Cronbach-α = 0.946). It included questions about (age, educational level, obstetric history, medical and surgical history...) and a measure of maternal satisfaction with spinal anesthesia (It consisted of six topics containing 25 items) and was based on a three-point Likert scale as follows: 1: dissatisfied, 2: neutral, and 3: satisfied.

The first subscale, “Perioperative evaluation and evaluation,” measures the level of satisfaction regarding preoperative evaluation. The second subscale, “Pain Treatment,” measures the mothers’ level of satisfaction regarding the pain they experience during and after the anesthesia procedure. The third subscale, “Attention by the Anesthesiologist,” measures the level of satisfaction regarding the attention the anesthesiologist gives them during Duration of surgery. The fourth subscale, “Anesthesiologist-Patient Relationship,” measures the level of satisfaction regarding the interpersonal relationship between the anesthesiologist and mothers. The fifth subscale, “Postoperative Care,” measures the level of satisfaction regarding the postoperative care provided to them. The sixth subscale, “Quality of Care,” measures the level of satisfaction regarding the quality of care provided to them.

Statistical analysis

Patient data was tabulated and entered into the computer, and then the Statistical Package for the Social Sciences (SPSS) version (26) was used to analyze this data. The following statistical methods were relied upon in the analysis

The number of participants was 120 women, whose ages ranged between 21–50 years, with an average age of 30.25 and a standard deviation of 6.7 years (Table 1). The education level of the largest percentage of participants was university education, 86 (71.7%), followed by secondary education, 19 (15.8%), then middle school, 13 (10.8%) (Table 2). It was found that the largest percentage of female participants were not working, as their percentage reached 91 (75.8%) compared to those who had a job, 29 (24.2%) (Table 3). All 120 (100%) participants were married (Table 4).

Table 1
Age
Minimum	Maximum	Mean	Std. Deviation
21	50	30.25	6.783

Table 2
		N	%
Educational level	primary education	2	1.7
	Preparatory education	13	10.8
	high school education	19	15.8
	University education	86	71.7
Total		120	100

Table 3
		N	%
Professional status	employee	29	24.2
Professional status	Not employed	91	75.8
Total		120	100

Table 4
		N	%
marital status	Married	120	100

It was found that more than half of the participants were primiparous women, 79 (65.8%), compared to primiparous women, 41 (34.2%) (Table 5). Regarding the birth weight of the newborn, the “less than 3Kg” category reached 72 (60%), compared to the “More than 3Kg” category 48 (40%) (Table 6).

Table 5

		N	%
Reproductive status	first birth	41	34.2
Reproductive status	Viviparous	79	65.8
Total		120	100

Table 6

		N	%
Newborn weight at birth?	Less than 3Kg	72	60
Newborn weight at birth?	More than 3Kg	48	40
Total		120	100

We found that only 28 (23.3%) of the participants had a medical history (Table 7). The percentage of participants who had previously undergone anesthesia was 79 (65.8%) (Table 8). The method to which they underwent a greater percentage was general anesthesia 9 (7.5%), compared to spinal anesthesia 70 (58.3%) (Table 9). When asked about complications resulting from exposure to anesthesia, more than half of the participants, 81 (67.5%), answered “no” (Table 10).

Table 7
		N	%
Does the patient have any medical history?	Yas	28	23.3
Does the patient have any medical history?	No	92	76.7
Total		120	100

Table 8
		N	%
Has the patient undergone anesthesia before?	Yas	79	65.8
Has the patient undergone anesthesia before?	No	41	34.2
Total		120	100

Table 9
		N	%
What is the way used?	General anesthesia (GA)	9	7.5
	Spinal anesthesia (SA)	70	58.3
	No, seriously	41	34.2
Total		120	100

Table 10
		N	%
complications from receiving anesthesia before?	Yas	39	23.5
complications from receiving anesthesia before?	No	81	67.5
Total		120	100

Regarding anesthesia complications, participants’ answers were as follows: back pain 33 (27.5%), pain 11 (9.1%), nausea and vomiting 6 (5%), and urinary retention 2 (1.6%). (Table 11) provides more information.

Table 11
		N	%
Complications of anesthesia?	(PONV) Postoperative nausea and vomiting	6	5%
	Urinary retention	2	1.6%
	pain	11	9.1%
	Back ache	33	27.5%
	Other	13	10.8%
	I did not suffer from any complications	81	67.5%

Only 30 (25%) of the participants reported experiencing pain during surgery (Table 12). Only 24 (20%) of them suffered from nausea and vomiting postoperatively (Table 13). When asked about their happiness with spinal anesthesia for caesarean section, more than half of them answered yes, 72 (60%) (Table 14). We found that those who answered that they were unhappy with spinal anesthesia were because they were suffering from one of its complications, and their order was as follows: headache after epidural biopsy 23 (19.1%), pain 16 (13.3%), fear of unconsciousness 14 (11.6%), nausea and vomiting 8 (6.6%) (Table 15).

Table 12
		N	%
Did you experience pain during the procedure?	Yas	30	25
Did you experience pain during the procedure?	No	90	75
Total		120	100

Table 13
		N	%
Did you experience nausea and vomiting after surgery?	Yas	24	20
Did you experience nausea and vomiting after surgery?	No	96	80
Total		120	100

Table 14
		N	%
Are you happy with spinal anesthesia for caesarean section?	Yas	72	60
	No	48	40
Total		120	100

Table 15
		N	%
If you answered (no) to the previous question, why?	Fear of awareness	14	11.6%
	pain	16	13.3%
	Nausea and vomiting	8	6.6%
	Headache after Dural biopsy	23	19.1%
	Other	7	5.8%

Study of participant satisfaction regarding spinal anesthesia:

(Table 16) shows the axes of the mothers’ satisfaction scale regarding spinal anesthesia, and their answers were as follows:

Table 16
			Satisfied	neutral	not satisfied	Mean	SD	Rank
Evaluation and evaluation of the surgical procedure	Satisfaction with the amount of information provided by anesthesiologists about anesthesia	N	56	34	30	2.22	0.822	3
		%	46.7	28.3	25	2.22	0.822	3
	Explanation of the process	N	62	30	28	2.28	0.822	1
	Explanation of the process	%	51.7	25	23.3	2.28	0.822	1
	An explanation of your stay in the operating room	N	60	23	37	2.19	0.882	4
	An explanation of your stay in the operating room	%	50	19.2	30.8	2.19	0.882	4
	Understandable information	N	56	36	28	2.23	0.807	2
	Understandable information	%	46.7	30	23.3	2.23	0.807	2
	Sufficient explanation of the feeling after anesthesia	N	44	37	39	2.04	0.834	6
	Sufficient explanation of the feeling after anesthesia	%	36.7	30.8	32.5	2.04	0.834	6
	Satisfaction with the preoperative visit	N	48	39	33	2.13	0.815	5
	Satisfaction with the preoperative visit	%	40	32.5	27.5	2.13	0.815	5
	Satisfaction with information about postoperative complications	N	36	43	41	1.96	0.803	7
		%	30	35.8	34.2	1.96	0.803	7
Pain treatment	Satisfaction with postoperative pain	N	26	43	51	1.79	0.777	3
	Satisfaction with postoperative pain	%	21.7	35.8	42.5	1.79	0.777	3
	How satisfied are you with the lack of pain at the puncture site?	N	62	36	22	2.33	0.771	2
		%	51.7	30	18.3	2.33	0.771	2
	Satisfaction with the lack of pain during the operation	N	72	20	28	2.37	0.84	1
	Satisfaction with the lack of pain during the operation	%	60	16.7	23.3	2.37	0.84	1
Attention anesthesiologist	Satisfaction with the anesthesiologist's attention to your complaints such as pain and nausea	N	70	26	24	2.38	0.801	3
		%	58.3	21.7	20	2.38	0.801	3
	Satisfaction with the anesthesiologist's willingness to listen to your questions	N	70	27	23	2.39	0.792	2
		%	58.3	22.5	19.2	2.39	0.792	2
	Work according to your needs	N	64	36	20	2.37	0.755	4
	Work according to your needs	%	53.3	30	16.7	2.37	0.755	4
	Show the anesthesiologist an understanding of your condition	N	72	25	23	2.41	0.794	1
		%	60	20.8	19.2	2.41	0.794	1
The relationship between the anesthesiologist and the patient	Did the anesthesiologist respect your privacy?	N	82	21	17	2.54	0.732	2
	Did the anesthesiologist respect your privacy?	%	68.3	17.5	14.2	2.54	0.732	2
	Respect/polite the anesthesiologist	N	87	14	19	2.57	0.753	1
	Respect/polite the anesthesiologist	%	72.5	11.7	15.8	2.57	0.753	1
	Did the anesthesiologist take your cultural background into account?	N	60	41	19	2.34	0.739	3
		%	50	34.2	15.8	2.34	0.739	3
	Satisfaction with the opportunity to make your own decision about the type of anesthesia you received	N	70	16	34	2.3	0.885	4
		%	58.3	13.3	28.3	2.3	0.885	4
Postoperative care	Satisfaction with post-operative visits to anesthesiologists	N	44	36	40	2.03	0.84	2
		%	36.7	30	33.3	2.03	0.84	2
	Satisfaction with treatment for postoperative nausea and vomiting (PONV)	N	54	31	35	2.16	0.85	1
		%	45	25.8	29.2	2.16	0.85	1
Quality care	Your satisfaction with the waiting time between your arrival in the operating room and the operation	N	65	28	27	2.32	0.82	2
		%	54.2	23.3	22.5	2.32	0.82	2
	Your satisfaction with receiving the same anesthesia again	N	60	31	29	2.26	0.825	4
	Your satisfaction with receiving the same anesthesia again	%	50	25.8	24.2	2.26	0.825	4
	Your degree of trust in anesthesia practitioners	N	56	51	13	2.36	0.671	1
	Your degree of trust in anesthesia practitioners	%	46.7	42.5	10.8	2.36	0.671	1
	The degree to which you can find a specialized anesthesiologist	N	58	39	23	2.29	0.771	3
		%	48.3	32.5	19.2	2.29	0.771	3
	Recommendation by the anesthesia team to others in your family	N	47	54	19	2.23	0.707	5
		%	39.2	45	15.8	2.23	0.707	5

The first axis (evaluation and evaluation of the surgical procedure): Only (46%) of the mothers were satisfied with the information provided by the anesthesiologists before the surgical procedure. Although the mothers had a good understanding of the little preoperative information, more than half (60%) of them were not satisfied with the preoperative visit to the anesthesiologist. The total satisfaction for this axis was (43%).

The second axis (pain treatment): More than half of the mothers (51.7%) were satisfied with the absence of pain during the lumbar puncture, and a larger percentage (60%) were satisfied with the control of pain during the operation, but the treatment of pain after surgery was not satisfactory for (42.5%) of mothers. The total satisfaction for this axis was (44.4%).

The third axis (the anesthesiologist’s attention): A large percentage of mothers were satisfied with the care provided by the anesthesiologists during the operation, as more than half (58.3%) of them were satisfied with the anesthesiologist’s interest in their complaints, their sympathy, and their willingness to listen to their questions and needs. The total satisfaction for this axis was (57.5%).

Fourth axis (the relationship between the anesthesiologist and the patient): (72.5%) of the mothers were satisfied with the anesthesiologists’ politeness, but regarding taking into account their cultural/ethnic background, the satisfaction level reached (50%). However, the mothers’ participation in determining the type of anesthesia they receive It was (58.3%). The total satisfaction for this axis was (62.2%).

Axis Five (follow-up of mothers after the operation by the anesthesiologist): Only (45%) of the mothers expressed their satisfaction with the treatment of nausea and vomiting after surgery, and only (36.7%) of them felt satisfied with the follow-up/visit of the anesthesiologist after surgery. Overall satisfaction for this axis (40.8%).

Axis Six (Quality of Care): Of the total participants, only (46.7%) were satisfied with the quality of care of anesthesiologists, including their practices, professionalism, and skills. (50%) were satisfied with undergoing this type of anesthesia again. Overall satisfaction for this axis (47.6%).

Overall Satisfaction: Participants had an overall satisfaction of 49.3% with the anesthesia services for spinal anesthesia.

Researching patient satisfaction is important because it helps us improve the quality of anesthesia [24]. Several aspects of perioperative care that could influence maternal satisfaction were evaluated.

The overall satisfaction rate of mothers with the spinal anesthesia service for caesarean sections was (49.3%). We can consider it somewhat acceptable compared to the Ethiopian study [25] where it was (62%), but it is much lower compared to the Malaysian study [24] which reported a rate Satisfaction rate (97%). Differences in satisfaction rates can be attributed to differences in equipment and capacity between these countries.

Several studies have identified poor preoperative communication as an important negative predictor of maternal satisfaction [27]. Likewise, in our study, low maternal satisfaction with preoperative evaluation was reported, accounting for 40% of the satisfaction rate. Satisfaction with pre-anesthetic information about the procedure was low (36%) in a study conducted at Kisumu District Hospital [26]. The percentage in our study was also low, reaching (46.7%). The small number of anesthesiologists may be the most likely reason for not providing sufficient information.

The postoperative visit or follow-up was also among the aspects that were ignored, as (33.3%) of the mothers were dissatisfied due to the lack of a visit to the anesthesiologist or follow-up after surgery. However, maternal satisfaction was high with attention and communication from anesthesiologists during the surgical procedure (58.3%). These findings clearly indicate negligence in preoperative and postoperative clinical anesthesia practices.

Lack of preoperative information is a problem in many developing countries including Syria. In addition to its psychological importance for mothers, preoperative assessment is an indicator of professional competence and quality of anesthesia care. Preoperative and intraoperative anesthesia are equally important, and it is the anesthesiologist's responsibility to perform the preoperative assessment. The lack of communication and evaluation before surgery makes mothers lose confidence, which negatively affects their satisfaction. Anesthesiologists need to expand their practice in preoperative and postoperative care rather than being limited only to intraoperative management. Hence, regulatory bodies and health training institutions need to increase the number of trained anesthetists.

The level of mothers’ satisfaction with their participation in the decision in determining the type of anesthesia they receive was acceptable, meaning that (58.3%) were satisfied. Ethically and legally, any patient has the right to choose the care he receives; However, time constraints on the one hand and the burden on patients on the other hand make anesthesiologists choose the preferred technique without considering maternal choice.

Intraoperative pain assessment is an important factor to rule out failure of nerve block. Many anesthesia providers claim that spinal anesthesia provides complete analgesia during and immediately after surgery, but failure may occur. In our study, there was a good level of maternal satisfaction with pain control, reaching (60%). Similar results for pain control have been reported from a Kenyan study [29], although very few studies have been conducted on intraoperative pain, with most studies focusing on postoperative pain, demonstrated intraoperative pain control in Pakistan [28] A satisfactory score of (74%). The difference may be due to the timing of data collection. The study conducted in Pakistan had no limits on the time of postpartum data collection. Therefore, late adverse effects of spinal anesthesia such as postdural puncture headache were more likely to occur in the Pakistani study. The importance of this finding indicates that spinal anesthesia, especially bupivacaine, is effective in controlling pain during and immediately after surgery.

Literature findings indicated that the difference in awareness between highly educated and less educated mothers towards health services affects their satisfaction due to the high expectations of relatively highly educated patients. For example, in a study conducted at Jimma Hospital, dissatisfaction increased with increasing educational level but decreased with increasing age of participants [25, 29]. In contrast, our results indicated no statistical significance regarding the relationship between mothers' education levels and their satisfaction.

The experience of pain during the procedure had a significant impact on maternal dissatisfaction. Although spinal anesthesia is expected to prevent pain, some patients may experience pain either due to insufficient anesthesia or due to differences in psychological perception among patients. In our study, 25% of mothers were in pain and were dissatisfied; This indicates the significant impact of pain on maternal satisfaction. We did not use any pain assessment tool because our goal was not to assess the level of pain, only to ask them whether they felt pain or not.

There was better satisfaction with management of postoperative nausea and vomiting (PONV) with 80% of mothers being satisfied. The fact that they were given antiemetic prophylaxis and that most patients were punctured with a small spinal needle may have reduced dissatisfaction with PONV.

Refusal to receive spinal anesthesia in the future may be a negative indicator of satisfaction with the current spinal anesthesia experience. The study revealed a future rejection rate for spinal anesthesia of (24.2%). Post-Dural biopsy headache was the main reason (19.1%) for which mothers declined future surgery, followed by intraoperative pain (13.3%). Other studies have found variable rejection rates. Our study found a similar rejection rate to studies conducted in Greece 20% [32], the Czech Republic 30% [31], and Ethiopia 18% [25]. It can be concluded that the reasons for future refusal of spinal anesthesia are more or less similar. This rejection can be reduced by explaining the advantages of spinal anesthesia (SA) over general anesthesia (GA).

Declarations Ethical statement:

The ethical consent was obtained from Syrian private university ethical committee Competing Interest: the authors declare no competing of interests.

Availability of data and materials:

All data are available from the corresponding author on reasonable request.

Funding:

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Apfelbaum JL, Hawkins JL, Agarkar M et al (2016) 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 124(2):270–300
Rhee WJ, Chung CJ, Lim YH, Lee KH, Lee SC (2010) Factors in patient dissatisfaction and refusal regarding spinal anesthesia. Korean J Anesthesiology 59(4):260
Smaoui M, Ayedi M, Derbel A, Barkia R, Akrout S, Kolsi K (2012) Factors of patient dissatisfaction after spinal anesthesia for cesarean section. Eur J Anaesthesiol 29:164
Sadeghi M, Bayat R, Azimaraghi O, Saliminia A (2017) Maternal satisfaction of spinal anesthesia for elective cesarean section in an academic hospital. Annals Anesthesiology Crit Care, 2, 2
Altiparmak B, Koseoglu SB (2017) Assessment of satisfaction and anxiety levels of the patients who had cesarean section with general and spinal anesthesia. Int Med J 6(2):229–232
Kimani K (2016) Maternal Satisfaction with Spinal Anesthesia for Cesarean Delivery. Kenyata National Hospital, Nairobi, Kenya
Gibbons L, Belizan JM, Lauer JA, Merialdi AP, Althabe F (2010) ) e global numbers and costs of additionally needed and unnecessary caesarean sections performed per year: overuse as a barrier to universal coverage, World Health Report, vol. 30, no. 1, pp. 1–31
Stourac P, Blaha J, Klozova R et al (2015) Anesthesia for cesarean delivery in the Czech Republic. Anesth Analgesia 120(6):1303–1308
Broaddus BM, Chandrasekhar S (2011) Informed consent in obstetric anesthesia. Anesth Analgesia 112(4):912–915
Gebremedhn EG, Nagaratnam V (2014) Assessment of patient satisfaction with the preoperative anesthetic evaluation. Patient Relat Outcome Measures 5:105
Siddiqi R, Jafri SA (2009) Maternal satisfaction after spinal anesthesia for caesarean deliveries. J Coll Physicians Surgeons—Pakistan: JCPSP 19(2):77–80
Azari S, Sehaty F, Ebrahimi H (2013) Satisfaction of women from cesarean section care services in public and private hospitals of Tabriz. Iran J Nurs Midwifery Res 18(6):435–438
Hobson JA, Slade P, Wrench IJ, Power L (2006) Preoperative anxiety and postoperative satisfaction in women undergoing elective caesarean section. Int J Obstet Anesth 15(1):18–23
Ministry of Health (2017) Health Management Information System. Ministry of Health, Eritrea
Juhani TP, Hannele H (1993) Complications during spinal anesthesia for cesarean delivery: a clinical report of one year’s experience. Reg Anesth Pain Med 18(2):128–131
Harazim H, Stourac P, Blaha J et al (2019) ) e influence of mode of anaesthesia for caesarean delivery on neonatal Apgar scores in the Czech Republic and Slovakia: secondary analysis of the results of an international survey in 2015. Biomedical Papers 163(2):147–154
Muneer MN, Malik S, Kumar N, Anwar S (2016) Causes of refusal for regional anaesthesia in obstetrics patients. Pakistan J Surg 32(1):39–43
Myles PS, Williams DL, Hendrata M, Anderson H, Weeks AM (2000) Patient satisfaction after anaesthesia and surgery: results of a prospective survey of 10,811 patients. Br J Anaesth 84(1):6–10
Caljouw MAA, van Beuzekom M, Boer F (2008) Patient’s satisfaction with perioperative care: development, validation, and application of a questionnaire. Br J Anaesth 100(5):637–644
Dharmalingam TK, Ahmad Zainuddin NA (2013) Survey on maternal satisfaction in receiving spinal anaesthesia for caesarean section. e Malaysian J Med Sciences: MJMS 20(3):51
Ida M, Enomoto J, Yamamoto Y, Onodera H, Kawaguchi M (2018) Factors associated with anesthetic satisfaction after cesarean delivery under neuraxial anesthesia. J Anesth Clin Rep 4(1):66
Dharmalingam TK, Zainuddin NA (2013) Survey on maternal satisfaction in receiving spinal anaesthesia for caesarean section. 2e Malaysian J Med Sciences: MJMS 20(3):51–54
Belay D (2015) Maternal satisfaction after spinal anesthesia for caesarean delivery, Doctoral dissertation, Addis Ababa University, Ababa, Ethiopia
Dharmalingam TK, Zainuddin NA (2013) Survey on maternal satisfaction in receiving spinal anaesthesia for caesarean section. 2e Malaysian J Med Sciences: MJMS 20(3):51–54
Belay D (2015) Maternal satisfaction after spinal anesthesia for caesarean delivery, Doctoral dissertation, Addis Ababa University, Ababa, Ethiopia
Senghor MS, Morema EN (2017) Determinants of maternal satisfaction with spinal anaesthesia care for caesarian delivery at the Kisumu County Hospital. IOSR J Nurs Health Sci (IOSR-JNHS) 6(1):91–95
Ha JF, Longnecker N (2010) Doctor-patient communication: a review. 2e Ochsner J 10(10):38–43
Siddiqi R, Jafri SA (2009) Maternal satisfaction after spinal anaesthesia for caesarean deliveries. J Coll Physicians Surgeons—Pakistan: JCPSP 19(2):77–80
Oljira L, Gebre-Selassie S (2001) Satisfaction with outpatient health services at Jimma hospital, South West Ethiopia. Ethiop J Health Dev 15(3):179–184
Kimani AK (2016) Maternal Satisfaction with Spinal Anesthesia for Cesarean Delivery. Kenyata National Hospital, Nairobi, Kenya
Stourac P, Blaha J, Klozova R et al (2015) Anesthesia for cesarean delivery in the Czech Republic. Anesth Analgesia 120(6):1303–1308
Fassoulaki A, Staikou C, Melemeni A, Kottis G, Petropoulos G (2010) Anaesthesia preference, neuraxial vs general, and outcome after caesarean section. J Obstet Gynaecol 30(8):818–821

The authors declare no competing interests.

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Study of maternal satisfaction and associated factors toward spinal anesthesia for cesarean section: a cross-sectional study

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