Knowledge, perception and factors associated with preference of anaesthesia techniques among women in antenatal ward, Kawempe National Referral Hospital

Abstract

Introduction: Caesarean Section (CS) rates in Uganda are increasing and the preferred technique for CS are general anaesthesia (GA) or regional anaesthesia (RA). Among the many myths about anaesthesia in Uganda are “fear of exchange of babies” and” we shall never walk again”. The factors that determine preference of particular anaesthesia techniques had not been studied in our setting. Having knowledge of the anaesthesia techniques used for CS assist in making an informed choice of the anaesthesia technique and reduces unnecessary anxiety before the surgery. General objective: To assess knowledge, perception of anaesthesia techniques and factors associated with preference among women in antenatal ward of Kawempe National Referral Hospital. Methods: We conducted a cross-sectional study among pregnant women in the antenatal ward of Kawempe National Referral Hospital. A systematic random sampling technique was used and quantitatively collected data from 413 pregnant women during the study period. Information regarding socio-demographic and clinical characteristics, knowledge of anaesthesia techniques and their complications, preference of anaesthesia techniques and factors that determine preference of a particular anaesthesia technique was obtained. Results: A total of 395 women aged 14-43 years were recruited. Only 167(57.7%) women interviewed had experienced CS all of whom 167(100.0%) were knowledgeable about different anaesthesia techniques used for CS. RA among those who had a choice of anaesthesia technique was preferred by 303(86.6%) women compared to general anaesthesia. Pregnant women who were aged 21-25 years were 63% less likely to prefer general anaesthesia compared to those above 30 years of age, aOR 0.37, 95%CI (0.183-0.759), p-value 0.007. Similarly, pregnant women who were aged 26-30 years were 65% lesslikely to choose general anaesthesia compared to those above 30 years of age, aOR 0.35, 95%CI (0.169-0.729), p-value 0.005. This observation however was not biologically plausible. Conclusion and recommendation: Considering the fact that the global trend is towards regional anaesthesia due to lower morbidity and mortality, the high preference for regional anaesthesia in our study was good. However, health education during antenatal care should incorporate anaesthesia information so that appropriate detailed messages can be obtained from the health workers and more pregnant women encouraged selecting regional over general anaesthesia in circumstances where no contraindication for regional anaesthesia exist.