Štourač P, Bláha J, Nosková P, Klozová R, Seidlová D, Jarkovský J, Zelinková H, Skupina Obaama-Cz Studijní
Ceska Gynekol. 2015 Mar;80(2):127-34.
The aim of national survey was to describe current practice for analgesia during labour provided by anaesthesiologists in the Czech Republic (CZE).
National prospective observational.
49 obstetric departments in CZE.
We aimed to enrol all 97 obstetric departments in CZE and to monitor every case of anaesthetic care in peripartum period during November 2011. Data were recorded to Case Report Form with two parts (Demography 2010 and Case Report) into TrialDB database (Yale University, USA; adapted IBA, MU, CZE). Demographic data for CZE were obtained on request by ÚZIS. The data were analysed using SPSS 22.
We enrolled 1943 cases of anaesthesiological care and 579 (29.8%) of them was to relief labour pain. Population and center weighted estimate of incidence of epidural labour analgesia was 12.5% (95% CI: 10.6% - 14.4%). Epidural analgesia was the most frequently applied via Tuohy needle G18 (97.8%), with administration of an epidural catheter G20 (95.7%), via medial approach (98.8%), in lateral position (76.7%) by the loss of resistance method (94.3%). All administrations of epidural analgesia were started by initial bolus, only in 28.2% of cases were followed continously. Always has been applied mixture of local anaesthetic with sufentanil at a dose of 3-10 mcg. Bupivacaine was most frequently used local anaesthetic (80.7%), followed by levobupivacaine (12.6%). Median concentrations both bupivacaine and levobupivacaine were 0.125% (min. 0.1%, max. 0.3%).The most common complication of epidural analgesia was repeated puncture (21.2%), blood in the catheter (1.4%), blood in the needle (1.2%), unintended puncture of the dura mater (0.7%) and transient paresthesias (0.5%).
In comparison to previously published data there was trend for lower incidence of epidural analgesia for labour in the CZE.
这项全国性调查的目的是描述捷克共和国麻醉医生在分娩期间提供镇痛的当前做法。
全国前瞻性观察性研究。
捷克共和国的49个产科部门。
我们旨在纳入捷克共和国所有97个产科部门，并监测2011年11月围产期的每一例麻醉护理病例。数据记录在病例报告表的两个部分（2010年人口统计学和病例报告）中，并录入TrialDB数据库（美国耶鲁大学；由捷克共和国马萨里克大学医学院改编的国际生物医学工程学会数据库）。捷克共和国的人口统计数据由ÚZIS根据要求提供。使用SPSS 22对数据进行分析。
我们纳入了1943例麻醉护理病例，其中579例（29.8%）用于缓解分娩疼痛。硬膜外分娩镇痛发生率的人群和中心加权估计值为12.5%（95%可信区间：10.6% - 14.4%）。硬膜外镇痛最常通过18G Tuohy针进行（97.8%），使用20G硬膜外导管给药（95.7%），采用内侧入路（98.8%），在侧卧位（76.7%）通过阻力消失法进行（94.3%）。所有硬膜外镇痛给药均以初始推注开始，仅28.2%的病例进行了持续给药。始终使用局部麻醉药与舒芬太尼的混合剂，剂量为3 - 10微克。布比卡因是最常用的局部麻醉药（80.7%），其次是左旋布比卡因（12.6%）。布比卡因和左旋布比卡因的中位浓度均为0.125%（最低0.1%，最高0.3%）。硬膜外镇痛最常见的并发症是重复穿刺（21.2%）、导管内有血（1.4%）、针内有血（1.2%）、意外刺破硬脊膜（0.7%）和短暂感觉异常（0.5%）。
与先前公布的数据相比，捷克共和国硬膜外分娩镇痛的发生率有下降趋势。
