title: Comparison of predicted and perceived pain from epidural and spinal puncture in patients undergoing elective caesarean section.
abstract: The 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.
authors.affiliation: Department of Anaesthesiology, National Hospital Organisation Miyakonojo Hospital, Miyazaki, Japan. yanotake@fc.miyazaki-u.ac.jp
authors.forename: T
authors.initials: T
authors.lastname: Yano
authors.forename: T
authors.initials: T
authors.lastname: Iwasaki
authors.forename: H
authors.initials: H
authors.lastname: Naruo
authors.forename: I
authors.initials: I
authors.lastname: Tsuneyoshi
mesh_terms: D000328:Adult; D000767:Anesthesia, Epidural / Q000009:adverse effects*; D000773:Anesthesia, Obstetrical / Q000009:adverse effects*; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D002585:Cesarean Section; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D009339:Needles; D010146:Pain / Q000209:etiology* / Q000523:psychology; D010147:Pain Measurement; D011237:Predictive Value of Tests; D011247:Pregnancy