• Anaesth Intensive Care · Jul 2011

    Comparative Study

    Comparison of predicted and perceived pain from epidural and spinal puncture in patients undergoing elective caesarean section.

    • T Yano, T Iwasaki, H Naruo, and I Tsuneyoshi.
    • Department of Anaesthesiology, National Hospital Organisation Miyakonojo Hospital, Miyazaki, Japan. yanotake@fc.miyazaki-u.ac.jp
    • Anaesth Intensive Care. 2011 Jul 1;39(4):646-9.

    AbstractThe intensity of pain expected by patients before an epidural and/or a spinal puncture is uncertain. The main purpose of this study was to identify and compare the intensity of pain predicted and perceived by patients having an epidural and a spinal procedure. After screening for relevant exclusion criteria, 50 women who were undergoing elective caesarean section under combined spinal-epidural anaesthesia (double-segment technique) were enrolled in the study. Infiltration anaesthesia prior to needle insertion was performed for the epidural but not the spinal puncture. Pain assessments, using a 100 mm visual analogue pain scale, were made before (predicted pain) and after (perceived pain) the epidural and the spinal puncture. Predicted pain for epidural and spinal insertion (epidural 60.6 +/- 20.5 mm, spinal: 55.1 +/- 24 mm) was significantly higher than the pain perceived (epidural 36.3 +/- 20 mm, spinal 46.1 +/- 23.2 mm) (epidural P < 0.001, spinal P = 0.031). Patients who were scheduled for an elective caesarean section under combined spinal-epidural anaesthesia predicted 1.2- to 1.7-fold stronger pain intensity than they perceived during the procedure. Patients should be informed that a regional anaesthetic, especially epidural, procedure is often less painful than the patient's expectation.

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