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Korean J Anesthesiol > Volume 56(2); 2009 > Article
Korean Journal of Anesthesiology 2009;56(2):156-161.
DOI: https://doi.org/10.4097/kjae.2009.56.2.156   
Analysis of factors related to patient refusal of spinal anesthesia.
Jun Gwon Choi, Junyong In, Hong Il Shin
Department of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang, Korea. cjanes@duih.org
Abstract
BACKGROUND
Spinal anesthesia is a anesthetic technique that can be easily used and practically applied according to patient's preference and physiologic status, surgical procedures and so forth. The purpose of the present study is to analyze factors related to patient refusal of spinal anesthesia, arising from the previous spinal anesthesia experience associated with side effects or unsatisfactory senses after spinal anesthesia.
METHODS
One hundred ninety four patients undergoing various surgical procedures under spinal anesthesia were enrolled. We made a questionnaire that consisted of examination items and question items, and checked it during spinal anesthesia and about 24 hours after spinal anesthesia. Factors related to patient refusal of spinal anesthesia were analyzed with multiple logistic regression.
RESULTS
Thirty one out of 194 patients (16%) rejected to receive spinal anesthesia if they would have chance to have it again. Significant factors associated with refusal of spinal anesthesia were low back pain (P = 0.005), needle type (Quincke) (P = 0.025) and tingling sensation in the lower extremities immediately after spinal anesthesia induction (P = 0.003). Low back pain was significantly associated with the number of attempts of spinal block (P = 0.023).
CONCLUSIONS
Factors related to patient refusal of spinal anesthesia are low back pain, needle type and tingling sensation. Low back pain is related to the number of attempts of spinal block. Practitioners should give patients appropriate information about spinal anesthesia preoperatively and consider using Whitacre needle and avoid multiple attempts of spinal block so as to increase patient's compliance with spinal anesthesia.
Key Words: Low back pain; Refusal; Spinal anesthesia
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