The relationship between anxiety and satisfaction level in women who had cesarean section with spinal or general anesthesia Anxiety and satisfaction level in cesarean section

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Semra Eroglu
Alperen Eroglu
Vusale Aziz
Songül Simar
Sibel Mutlu


Objective: Although regional anesthesia is frequently used in cesarean section, patient satisfaction and comfort can change with the anesthesia method preference. Our aim is to determine the level of anesthesia satisfaction in women with cesarean surgery with Spinal (SA) and General anesthesia (GA) and to examine its relationship with anxiety level.

Material and Methods: In this prospective observational cohort study, 144 pregnant women who were admitted to the Obstetrics and Gynecology Clinic between January 2019 and April 2019 were included. Demographic information of the pregnant women including age, height, weight, gestational history and education level were recorded. Hospital Anxiety and Depression Scale (HADS), preoperative anxiety levels and which anesthesia method they preferred were questioned and recorded.

Results: 72 SA and 72 GA patients were included in the study. Age, BMI (Body mass index), obstetric history, preoperative HADS were similar in both groups (p> 0.05). Patients with SA were significantly higher satisfaction level than those who had cesarean with GA (p = 0.000). Anxiety level during cesarean was correlated positively with preoperative HADS (p = 0.001, p = 0.005, respectively). First analgesia requirement didn’t differ in both group (p=0.409).

Conclusion: The satisfaction score founded higher in those who were cesarean with SA. Evaluating anxiety levels of patients and providing support before surgery will increase postoperative comfort.


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ErogluS., ErogluA., AzizV., SimarS., & MutluS. (2020). The relationship between anxiety and satisfaction level in women who had cesarean section with spinal or general anesthesia . Medical Science and Discovery, 7(7), 560-565.
Research Article


1. Carvalho B, Cohen SE, Lipman SS, Fuller A, Mathusamy AD, Macario A. Patient preferences for anesthesia outcomes associated with cesarean delivery. Anesthesia & Analgesia. 2005; 101(4): 1182-7. doi: 10.1213/01.ane.0000167774.36833.99

2. American Socirty of Anestesiologists Task Force on Obstetric Anesthesia. Practice guidelines for obstetric anesthesia: an updated report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia. Anesthesiology. 2007;106(4):843-63. doi:

3. Moon EJ, Go Y, Woo G, Seo H, Lee BJ. Preoperative anxiety can cause convulsion and severe hypotension immediately after spinal anaesthesia for caesarean delivery: a case report. Journal of International Medical Research. 2019; 47(10): 5323-7. doi:

4. Rosen S, Svensson M, Nilsson U. Calm or not calm: the question of anxiety in the perianesthesia patient. J Perianesth Nurs. 2008; 23: 237-46. doi: 10.1016/j.jopan.2008.05.002.

5. Sinesi A, Maxwell M, O’Carroll R, Cheyne H. Anxiety scales used in pregnancy: systematic review. B J Psych Open. 2019; 5: 1-13. DOI:

6. Kizilkaya T, Gul A. Parameters that Affect the Comfort Level of Pregnant Women Before Cesarean Section: Fasting and Anxiety. Journal of PeriAnesthesia Nursing. 2019; 34(6): 1265-73. doi: 10.1016/j.jopan.2019.05.135.

7. Rouhe H, Salmela-Aro K, Gissler M, Halmesmäki ME, Saisto T. Mental health problems common in women with fear of childbirth. BJOG 2011; 118: 1104-11. 10.1111/j.1471-0528.2011.02967.x

8. Todman D. A history of caesarean section: from ancient world to the modern era. Aust N Z J Obstet Gynaecol. 2007; 47:357–61.

9. Siddiqi R, Jafri SA. Maternal satisfaction after spinal anaesthesia for caesarean deliveries. J Coll Physicians Surg Pak. 2009; 19(2): 77–80. PMID: 19208308

10. Afolabi BB, Lesi FE. Regional versus general anaesthesia for caesarean section. Cochrane database of systematic reviews. 2010 (10). doi: 10.1002/14651858.CD004350.

11. Juhani TP, Hannele H. Complications during spinal anaesthesia for caesarean delivery: a clinical report of one year’s experience. Reg Anesth. 1993;18(2):128–131. PMID: 8489980

12. Rodgers A, Walker N, Schug S, McKee A, Kehlet H, Van Zundert A et al. Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: results from overview of randomised trials. Bmj. 2000; 321(7275): 1493. doi: 10.1136/bmj.321.7275.1493.

13. Teoh WH, Shah MK, Mah CL. A randomized controlled trial on beneficial effects of early feeding post-caesarean delivery under regional anaesthesia. Singapore Med J. 2007;48(2):152–7. PMID: 17304396.

14. Rhee WJ, Chung CJ, Lim YH, Lee KH, Lee SC. Factors in patient dissatisfaction and refusal regarding spinal anesthesia. Korean J Anesthesiol. 2010; 59(4): 260–264. Doi:10.4097/kjae.2010.59.4.260

15. Fassoulaki A, Staikou C, Melemeni A, Kottis G, Petropoulos G. Anaesthesia preference, neuraxial vs general, and outcome after caesarean section. Journal of Obstetrics and Gynaecology. 2010; 30(8): 818-21. DOI: 10.3109/01443615.2010.518650

16. Dharmalingam TK, Zainuddin NAA. Survey on maternal satisfaction in receiving spinal anaesthesia for caesarean section. The Malaysian journal of medical sciences. MJMS. 2013; 20(3): 51. PMID: 23966825

17. Hemanth Kumar V, Jahaqirdar SM, Athiraman UK, Sripriya R,Parthasarathy S, Ravishankar M. Study of patient satisfaction andself-expressed problems after emergency caesarean delivery under subarachnoid block. Indian J Anaesth. 2014;58(2):149-53. doi: 10.4103/0019-5049.130815

18. Belay D. Maternal Satisfaction after Spinal Anesthesia for Cesarean Delivery. 2015 July. (Doctoral dissertation, Addis Abeba University).

19. Altiparmak B, Koseoglu SB. Assessment of satisfaction and anxiety levels of the patients who had cesarean section with general and spinal anesthesia. Medicine. 2017; 6(2): 229-32. doi: 10.5455/medscience.2016.05.8544.

20. Down JF, Gowrie-Mohan S. A prospective observational study of the subjective experience of caesarean section under regional anaesthesia. International journal of obstetric anesthesia. 2002; 11(4): 242-5. DOI: 10.1054/ijoa.2002.0977.

21. Kan RK, Lew E, Yeo SW, Thomas E. General anesthesia for cesarean section in a Singapore maternity hospital: a retrospective survey. International journal of obstetric anesthesia. 2004; 13(4): 221-6. DOI: 10.1016/j.ijoa.2004.04.007.

22. Roy KE, George AM. Levels of Consciousness During Regional Anesthesia and Monitored Anesthesia Care: Patient Expectations and Experiences. A & A. 2009;108(5):1560–1563. doi: 10.1213/ane.0b013e31819c2aa3.

23. Jlala HA, Bedforth NM, Hardman JG. Anesthesiologists’ perception of patients’ anxiety under regional anesthesia. Local Reg Anesth. 2010; 3:65–71. doi:"11271.

24. Maheshwari D, Ismail S. Preoperative anxiety in patients selecting either general or regional anesthesia for elective cesarean section. Journal of anaesthesiology, clinical pharmacology. 2015; 31(2): 196. doi: 10.4103/0970-9185.155148.

25. Yigit Gunay E, Gul A. Reliability and validity of the Cambridge worry scale in pregnant Turkish women. Midwifery. 2015; 31:359-364.

26. Kushnir J, Friedman A, Ehrenfeld M, Kushnir T. Coping with preoperative anxiety in cesarean section: physiological, cognitive, and emotional effects of listening to favorite music. Birth. 2012; 39: 121-7.

27. Eley VA, Searles T, Donovan K, Walters E. Effect of an anaesthesia information video on preoperative maternal anxiety and postoperative satisfaction in elective caesarean section: a prospective randomised trial Anaesthesia and intensive care. 2013;41(6):774-81.

28. Ozturk Inal Z, Gorkem U, Inal HA. Effects of preoperative anxiety on postcesarean delivery pain and analgesic consumption: general versus spinal anesthesia. The Journal of Maternal-Fetal & Neonatal Medicine.2020; 33(2), 191-197.

29. Gorkem U, Togrul C, Sahiner Y, Yazla E, Gungor T. Preoperative anxiety may increase postcesarean delivery pain and analgesic consumption. Minerva anestesiologica. 2016; 82(9): 974-80.