Impact of Structured Preoperative Counseling on Anaesthesia Preference in Elective Cesarean Delivery: A Prospective Study.

OBJECTIVE

To assess changes in anaesthesia preference before and after structured preoperative counseling and to identify factors associated with anaesthesia preference among women scheduled for elective cesarean delivery.

METHODS

This prospective, single-center, single-arm, pre-post observational study included 200 pregnant women classified as the American Society of Anesthesiologists physical status II. Data were collected using a structured questionnaire assessing demographic characteristics, obstetric history, previous anaesthesia experience, level of knowledge, and anaesthesia preference, both before and after counseling. Statistical analyses were performed using SPSS version 22.0, and a P value < 0.05 was considered statistically significant.

RESULTS

At baseline, 53% of patients preferred spinal anaesthesia and 47% preferred general anaesthesia. Following counseling, the preference for spinal anaesthesia increased to 88.5% (P < 0.001). Increasing age was associated with a decreased likelihood of choosing spinal anaesthesia [odds ratio (OR)=0.94, 95% confidence interval (CI): 0.89-0.99], whereas higher education (OR=1.78, 95% CI: 1.05-3.02), prior knowledge (OR=1.65, 95% CI: 1.02-2.68), and previous spinal anaesthesia experience (OR=2.95, 95% CI: 1.65-5.28) were identified as independent predictors of spinal anaesthesia preference. No significant association was found between smoking and anaesthesia preference, or between comorbidities and anaesthesia preference. The postoperative satisfaction rate with the anaesthesia was 91.5%.

CONCLUSION

Following structured preoperative counseling, the preference for neuraxial anaesthesia increased among women scheduled for elective cesarean delivery. These findings suggest that standardized patient education may be a useful component of preoperative anaesthesia assessment.