Misconceptions about subarachnoid anesthesia block in the Egyptian female patients; causes and management

Background and aims: Spinal anesthesia (SA) is widely used for many surgeries and when compared to general anesthesia (GA), it has lower rates of complications. However, anxiety or refusal of regional technique in our country is common and multi factorial. This study tried to find the main causes of refusal of SA and to suggest different solutions for the associated anxiety. Methodology: 160 adult Egyptian female patients (over 18 y of age), ASA II, who were enrolled for elective cesarean delivery were included in this study. During a preoperative visit a questionnaire was given to those who refused SA to enquire about their worries about SA, and to suggest different solutions to relieve the anxiety associated with SA as well as to describe the most frequently associated complications. Results: Higher rate of SA acceptance was noticed among urban and employed patients with no effect of education on their decision. Fear of post spinal backache was the leading cause (90.75%) of refusal in patients, followed by fear of intraoperative pain in 85.83%, while fear of residual paralysis was the least common cause (13.33%). Sedation was the effective method to overcome anxiety during spinal aesthesia in 56.67% of patients. PONV represents the most frequent complication associated with SA, in 25.83% patients. Conclusion: In conclusion, urban residency and employment status positively affect the decision of SA acceptance, however; educational level has no effect. Post spinal backache and fear of intraoperative pain were the principle causes of SA refusal. Adequate sedation is the most effective method to alleviate anxiety from SA. PONV and hypotension are common unwanted complications of SA.