Background and Aims Neuroaxial techniques (NT) are commonly used for pain relief during labor. Many modalities have been introduced, each with advantages and disadvantages. The choice of the ideal approach is debatable and could be linked to various factors. We examined the factors associated with the choice of NT among a sample of parturients in Bissaya Barreto Maternity.

Methods This is a retrospective, observational study of all patients (n=598) who had caesarean section (c-section) during 2022. Data were obtained from anonymous clinical records. Data collected included anesthetic approach technique, urgency of the c-section, previous presence of active labor, BMI of the parturient and APGAR score of the newborn. A chi squared (Q) analysis and adjusted residuals (AR) were used to reveal the association between variables.

Results A total of 598 c-sections were done: 556 (93%) with NT and 42 (7%) under general anesthesia (GA). There was no association between the choice of NT and the BMI of the parturient (Q 26,35;p 0,15) or APGAR score (Q 42,11;p 0,11). In the absence of labor there were higher than expected counts of combined anesthesia (AR 3,9; p<0,01) and lower epidurals (AR -5,7;p<0,01). If spontaneous or induced labor, epidural was chosen in higher counts than expected (AR 3,0 and 3,1 respectively). Emergent c-sections were positively associated with GA (AR 7,7;p<0,01).

Conclusions GA was positively associated with emergent c-section. Epidural was negatively associated with elective c-sections and the absence of labor which was positively associated with combined anesthesia. BMI and APGAR were not related to the choice of anesthesia.