Literature DB >> 24193179

Current practice in obstetric anesthesia: a 2012 European survey.

C Staikou1, A Paraskeva, I Karmaniolou, A Mani, K Chondrogiannis.   

Abstract

BACKGROUND: New scientific findings are gradually implemented into daily clinical routine. The present questionnaire survey investigated the current practice in obstetric anesthesia in Europe.
METHODS: A 19-point questionnaire on obstetric anesthesia practices, regarding the techniques, drugs, fluids, vasopressors and safety measures, was uploaded on the site of the European Society of Anaesthesiology (21/12/2011 to 21/12/2012).
RESULTS: Three hundred and forty-one (341) completed questionnaires were analyzed. Single-shot subarachnoid anesthesia is preferred by 225 (66%) respondents in uncomplicated Cesarean deliveries and by 190 (55.7%) in preeclampsia. Most anaesthesiologists (N.=133, 39%) perform neuraxial techniques if platelet count exceeds 80000/mm3. In anticipated hemorrhage, general anesthesia is administered by 165 (48.4%) respondents. Anesthesia is induced with thiopental/succinylcholine by 193 (56.6%) survey participants, usually under cricoid pressure (N.=201, 58.8%). For prevention of the hypotension associated with regional anesthesia, coloading with 1L of crystalloid represents the most popular measure undertaken by 80 (40.2%) respondents, while vasopressors are not favored (N.=260, 76.2%). For hypotension treatment, ephedrine is preferred over phenylephrine by 124 (36.4%) versus 79 (23.2%) anesthesiologists. Supplemental oxygen is routinely administered to parturients receiving regional anesthesia by 176 (51.6%) respondents. The standard dose of oxytocin is 5IU, according to most answers (N.=160, 46.9%).
CONCLUSION: Subarachnoid anesthesia is mostly favored among European anesthesiologists, while general anesthesia is reserved only for cases with anticipated hemorrhage. Fluid coloading and phenylephrine have gained popularity, in line with current knowledge. Conversely, cricoid pressure, standard supplemental oxygen and high oxytocin doses ‑ though strongly questioned ‑ are still advocated by most anaesthesiologists.

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Mesh:

Year:  2013        PMID: 24193179

Source DB:  PubMed          Journal:  Minerva Anestesiol        ISSN: 0375-9393            Impact factor:   3.051


  11 in total

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2.  When was the last time you induced general anesthesia for cesarean section?

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4.  Maternal and fetal outcomes following unplanned conversion to general anesthetic at elective cesarean section.

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Review 7.  Increasing Regional Anesthesia Use in a Serbian Teaching Hospital through an International Collaboration.

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8.  Current Practice in Obstetric Anesthesia and Analgesia in Public Hospitals of Greece: A 2016 National Survey

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9.  Paucity of evidence for the effectiveness of prophylactic low-dose oxytocin protocols (<5 IU) compared with 5 IU in women undergoing elective caesarean section: A systematic review of randomised controlled trials.

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10.  Fluid loading therapy to prevent spinal hypotension in women undergoing elective caesarean section: Network meta-analysis, trial sequential analysis and meta-regression.

Authors:  Koen Rijs; Frédéric J Mercier; D Nuala Lucas; Rolf Rossaint; Markus Klimek; Michael Heesen
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