Clinic of Anesthesia, Aretaieio Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
Clinic of Anesthesia, Asklipieio Voulas General Hospital, Athens, Greece
Balkan Med J. 2018 Sep 21;35(5):394-397. doi: 10.4274/balkanmedj.2018.0083. Epub 2018 Jun 19.
This descriptive survey was to evaluate the use of regional anesthesia in obstetrics in Greek public hospitals.
The survey was conducted between March and August 2016. A structured questionnaire was sent to 50 anesthesia departments in Greek public hospitals with obstetric units.
The response rate was 94%. Data corresponding to 9475 cesarean and 8155 vaginal deliveries were collected. Regional anesthesia was used in 69.2% of all cesareans, with single shot spinal being the most popular (44.3% of all cesareans). Combined spinal-epidural anesthesia was used in 18.1% of all cesareans (35.1% in hospitals of Athens versus 7.9% outside Athens, p<0.001). Post-cesarean analgesia was applied with simple analgesics and systematic opioids (78.6%). Long-acting spinal opioids were rarely used (4.4% of spinal and spinal/epidurals). Labor epidural analgesia was applied in 19.1% of all vaginal deliveries (30.3% in Athens versus 13.1% outside Athens, p<0.001). Paracetamol and pethidine represented the standard labor analgesics in 48.9% and 55.3% of all hospitals. Intravenous remifentanil was used in 10.6% of hospitals (50% in Athens versus 2.5% outside Athens, p=0.002). In 48.9% of hospitals, mainly outside Athens, the anesthesiologists did not get involved in labor analgesia.
Regional anesthesia is the most common practice for cesareans in Greek public hospitals; however, the percentage of general anesthesia remains high. In addition, the use of labor epidural analgesia is limited in hospitals outside Athens.
本描述性调查旨在评估希腊公立医院产科中区域麻醉的应用。
调查于 2016 年 3 月至 8 月进行。向希腊公立医院的 50 个麻醉科发送了一份结构化问卷。
应答率为 94%。收集了 9475 例剖宫产和 8155 例阴道分娩的数据。区域麻醉用于 69.2%的所有剖宫产，单次脊髓麻醉最受欢迎（占所有剖宫产的 44.3%）。联合脊髓-硬膜外麻醉用于所有剖宫产的 18.1%（雅典医院为 35.1%，雅典以外医院为 7.9%，p<0.001）。剖宫产术后镇痛采用简单镇痛药和系统阿片类药物（78.6%）。长效脊髓阿片类药物很少使用（脊髓和脊髓/硬膜外的 4.4%）。所有阴道分娩中 19.1%应用分娩硬膜外镇痛（雅典为 30.3%，雅典以外为 13.1%，p<0.001）。48.9%的医院使用对乙酰氨基酚和哌替啶作为标准分娩镇痛药，占所有医院的 55.3%。10.6%的医院使用静脉瑞芬太尼（雅典为 50%，雅典以外为 2.5%，p=0.002）。在 48.9%的医院，主要是雅典以外的医院，麻醉师不参与分娩镇痛。
区域麻醉是希腊公立医院剖宫产最常见的做法；然而，全身麻醉的比例仍然很高。此外，雅典以外医院硬膜外分娩镇痛的应用有限。
