Surgical sensation during caesarean section: a qualitative analysis

•Patients experience visceral sensations under neuraxial anaesthesia.•Most patients do not report pain or distress.•Commonly reported sensations are pressure and movement of varying intensity.•Pre-operative counselling should address sensations, symptoms, and the environment.•Intra-operative counselling should involve updates and invitation of questions. Caesarean section (CS) is a major abdominal surgery performed usually on a young and healthy population under neuraxial anesthesia with little to no sedation. This creates a distinct surgical experience whereby patients are aware of the surgical process, physical sensations, and their environment. This study aimed to provide an in-depth descriptive assessment of subjective surgical experience during CS under regional anaesthesia. We expected the information gained would enhance our current understanding and better alleviate patient anxiety through informed counselling. This qualitative descriptive study was conducted at a Canadian academic centre. Twenty patients participated in semi-structured interviews within a week of CS, using an interview guide developed for this study. Patient medical records were reviewed to collect demographic and surgical information. Thematic analysis was conducted using an inductive approach to determine common themes. Nine themes were identified. Five themes were identified in the category of surgical sensation and four themes were identified in the category of peri-operative education. Patients commonly experienced pressure and movement sensations at varying intensity, and most did not experience pain. Environmental factors, including sounds and distraction by the newborn, affected perception of surgical sensation. Patients wish to receive pre-operative counselling regarding potential surgical sensations, as well as ongoing communication from their anaesthesiologist. These results can be used to guide informed discussions with patients and direct further investigation in this area.