Bláha J, Štourač P, Grochová M, Klozová R, Richterová S, Nosková P, Seidlová D, Zenkner V, Novotný A, Schwarz D, Ščamburová J, Kosinová M, Kufa Ch, Kirchnerová M, Macková J, Várošová L, Toboláková R, Cepák J, Firment J
First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.
Medical Faculty of Masaryk University and University Hospital Brno, Brno, Czech Republic.
Int J Obstet Anesth. 2018 Aug;35:42-51. doi: 10.1016/j.ijoa.2018.04.001. Epub 2018 Apr 7.
The purpose of this international survey was to describe the current practices and techniques of labor analgesia in the Czech Republic (CZE) and Slovakia (SVK).
All Czech and Slovak departments that provide obstetric anesthesia were invited to participate in a one-month (November 2015) prospective study that monitored in detail all peripartum anesthetic procedures delivered by anesthesiologists. Participating centers recorded all data on-line in the CLADE-IS database (Masaryk University, CZE).
The response rate was 71% (70 of 95 departments in CZE, 35 of 54 centers in SVK). Participating centers represented 87.7% of all births in CZE and 66.4% of all births in SVK during the study period. Analgesia for labor, administered by anesthesiologists, was recorded in 12.5% of deliveries (CZE 12.1%, SVK 13.4%). Epidural analgesia was used in most of the cases (CZE 97.2%, SVK 99.1%) whereas spinal (CZE 1.4%, SVK 0.9%) or combined spinal-epidural (CZE 0.5%, SVK 0.0%) and intravenous remifentanil analgesia (CZE 2.4%, SVK 0.0%) were used infrequently. One fifth of the labors with analgesia administered by anesthesiologists (CZE 20.2%, SVK 20.5%) terminated in cesarean section.
Although labor analgesia was available in all Czech and Slovak obstetric centers, only a small proportion of parturients received an effective method of labor pain relief (regional or intravenous analgesia).
这项国际调查的目的是描述捷克共和国（CZE）和斯洛伐克（SVK）目前的分娩镇痛实践和技术。
所有提供产科麻醉的捷克和斯洛伐克科室受邀参加一项为期一个月（2015年11月）的前瞻性研究，该研究详细监测麻醉医生实施的所有围产期麻醉程序。参与中心在CLADE-IS数据库（捷克马萨里克大学）中在线记录所有数据。
回复率为71%（捷克95个科室中的70个，斯洛伐克54个中心中的35个）。在研究期间，参与中心占捷克所有分娩的87.7%，占斯洛伐克所有分娩的66.4%。麻醉医生实施的分娩镇痛记录在12.5%的分娩中（捷克12.1%，斯洛伐克13.4%）。大多数情况下使用硬膜外镇痛（捷克97.2%，斯洛伐克99.1%），而很少使用脊髓麻醉（捷克1.4%，斯洛伐克0.9%）或腰麻-硬膜外联合麻醉（捷克0.5%，斯洛伐克0.0%）以及静脉注射瑞芬太尼镇痛（捷克2.4%，斯洛伐克0.0%）。由麻醉医生实施镇痛的分娩中有五分之一（捷克20.2%，斯洛伐克20.5%）以剖宫产结束。
尽管捷克和斯洛伐克的所有产科中心都提供分娩镇痛，但只有一小部分产妇接受了有效的分娩疼痛缓解方法（区域或静脉镇痛）。
