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剖宫产麻醉实践快照研究(ACCESS):注册中心的方案和基线特征。

Anaesthesia praCtice for Caesarean dElivery Snapshot Study (ACCESS): Protocol and baseline characteristics of registered centres.

机构信息

Division of Anesthesiology & Critical Care & Pain, Tel Aviv Sourasky Medical Center, affiliated with the Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv, Israel.

Service of Anaesthesia and Intensive Care, La Paz University Hospital, Madrid, Spain.

出版信息

Acta Anaesthesiol Scand. 2024 Aug;68(7):989-996. doi: 10.1111/aas.14427. Epub 2024 Apr 26.

Abstract

BACKGROUND

Specific guidelines to manage caesarean delivery anaesthesia are lacking. A European multicentre study, ACCESS investigates caesarean delivery anaesthesia management in European centres. In order to identify ACCESS participating centres, a registration survey was created.

OBJECTIVE

The aim of the current report is to describe the characteristics of ACCESS study participating centres, the rationale for the ACCESS study and the study methodology.

DESIGN AND SETTING

The ACCESS study is a European multicentre cross-sectional study to describe anaesthesia management for caesarean delivery (CD) using a snapshot (2-week) design. The ACCESS registration survey gathered: contact details for National Coordinators (NC); Lead Investigators (LI) per centre; centre annual CD volume; expected no. of CD during 2-week snapshot window; centre practice information; data collection language. The ACCESS registration survey was launched July 2022 (Google Forms, Google Inc., Mountain View, CA, USA) and distributed through personal connections, national and international societies, social media networks, during Euroanaesthesia 2023, through the European Society of Anaesthesiology and Intensive Care newsletter.

RESULTS

The ACCESS registration survey identified Lead Investigators for 418 centres, in 32 countries, representing an anticipated number of 15,073 CD cases over the planned 12-month study period. A median (range) of 20 (2 to 400) CD cases are anticipated per centre during the 2-week snapshot window. Most 366/418 (87.6%) centres are small, ≤2000 annual CD cases, 42 are medium 2000-5000 cases and 10 are large, ≥5000 annual CD cases. Registered centres reported in 134 (32.0%) centres that anaesthesia for caesarean delivery is performed mostly by a specialist obstetric anaesthesiologist.

CONCLUSION

The ACCESS registration survey revealed variability in volume and CD practice as well as training-levels and staffing among European countries. The ACCESS study (https://www.access-study.org/) aims to generate practice data to guide CD anaesthetic management strategies.

摘要

背景

目前缺乏专门针对剖宫产麻醉管理的指导方针。ACCESS 是一项欧洲多中心研究,旨在调查欧洲中心的剖宫产麻醉管理情况。为了确定参与研究的中心,我们创建了一份注册调查。

目的

本报告的目的是描述 ACCESS 研究参与中心的特征、ACCESS 研究的基本原理和研究方法。

设计和设置

ACCESS 研究是一项欧洲多中心横断面研究,旨在使用快照(2 周)设计描述剖宫产的麻醉管理。ACCESS 注册调查收集了以下信息:国家协调员(NC)的联系方式;每个中心的主要调查员(LI);中心每年的剖宫产量;预计在 2 周快照窗口期间进行的剖宫产数量;中心实践信息;数据收集语言。ACCESS 注册调查于 2022 年 7 月(Google 表单,Google Inc.,Mountain View,CA,美国)启动,并通过个人联系、国家和国际协会、社交媒体网络、2023 年欧洲麻醉学会和重症监护学会年会以及欧洲麻醉学会和重症监护学会通讯发布。

结果

ACCESS 注册调查确定了 418 个中心的主要调查员,分布在 32 个国家,预计在计划的 12 个月研究期间将进行 15073 例剖宫产。大多数中心(87.6%)预计在 2 周快照窗口期间进行 20(2-400)例剖宫产。366/418(87.6%)个中心为小中心,每年剖宫产量≤2000 例,42 个中心为中等中心,每年剖宫产量 2000-5000 例,10 个中心为大中心,每年剖宫产量≥5000 例。注册中心报告称,在 134 个中心(32.0%)中,剖宫产麻醉主要由妇产科麻醉专家执行。

结论

ACCESS 注册调查显示,欧洲各国在剖宫产量和实践以及培训水平和人员配备方面存在差异。ACCESS 研究(https://www.access-study.org/)旨在生成实践数据,以指导剖宫产麻醉管理策略。

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