Intra-operative sensation during caesarean delivery under neuraxial anaesthesia: A prospective cohort study mapping...

Neuraxial anaesthesia is commonly used for caesarean delivery, but intra-operative sensations such as pain, pressure and touch remain frequent and may affect patient experience.

To map intra-operative sensation during caesarean delivery under spinal anaesthesia, characterising sensation modality, intensity, anatomical location and bothersomeness across surgical phases.

Dual-centre, prospective cohort study.

Two tertiary care hospitals in Israel (Rabin Medical Centre and Soroka University Medical Centre).

One hundred and forty-six women aged at least 18 years undergoing elective caesarean delivery with spinal anaesthesia and uterine exteriorisation.

None.

Incidence and characteristics of pain, pressure and touch sensations measured using Verbal Numeric Scale (VNS); bothersomeness rates; temporal distribution across surgical phases.

Pain occurred in 22/146 patients (15.1%), most commonly during uterine exteriorisation (5.5%) and its reinsertion (5.2%) median maximum intensity was 5.0. Only two patients received analgesia. Pressure was reported by 134/146 patients (91.8%) and touch by 82/146 (56.2%), both most frequently during baby delivery. Median maximum intensity for both was 5.0. Despite high prevalence, pressure and touch were rarely bothersome (7.5 and 4.3% of events, respectively). Only four patients (2.7%) reported no sensations. Pain never occurred in isolation but was always accompanied by pressure and/or touch sensations.

Intra-operative sensation during caesarean delivery under spinal anaesthesia is common but usually well tolerated. Most patients experience pressure and touch, especially during delivery, but few find this distressing. These findings support tailored pre-operative counselling to improve maternal experience.