Department of Anesthesiology and Pain Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
BMC Anesthesiol. 2024 Sep 28;24(1):341. doi: 10.1186/s12871-024-02728-x.
Obstetric anesthesia guidelines are essential for standardizing obstetric anesthesia practices globally and ensuring high-quality patient care. However, practices may vary across different settings, and there are limited data from Arab countries. This study aims to gain insights into obstetric anesthesia practices in several major hospitals across Arab countries.
A questionnaire was emailed to 85 obstetric anesthesiologists/anesthesia chairpersons in major hospitals, including academic medical institutions and central hospitals, across 11/22 Arab countries. This survey gathered data on key structural and process-related obstetric anesthesia indicators.
Out of 85 contacted, we had 56 responses (65.8%), with 41 being fully completed, providing insights into obstetric anesthesia indicators. Regarding structure: 31 (76%) hospitals had an operating room adjacent to the delivery room, all had intensive care units, and 22 (54%) had a lead obstetric anesthesiologist. For equipment, 19 (46%) had a video laryngoscope in the delivery suite, and 20 (49%) occasionally used ultrasound for epidurals. Regarding process: 33 (81%) held regular meetings, and 21 (51%) conducted research. Before epidural and spinal procedures, 26 (63%) and 28 (68%) required coagulation studies for patients without a history of hemorrhagic complications, while 38 (93%) and 36 (88%) mandated a platelet count, respectively. For labor analgesia, 34 (83%) primarily used epidurals, and 15 (37%) placed preemptive catheters in high-risk pregnancies. For cesarean delivery, 40 (98%) used spinals, with 16 (39%) using intrathecal morphine and 22 (54%) administering aspiration prophylaxis before general anesthesia. Regarding spinal-induced hypotension, 6 (15%) used prophylactic phenylephrine infusion.
This survey highlights variations in obstetric anesthesia practices among various major hospitals in several Arab countries, compared to international recommendations. It emphasizes the need for obstetric anesthesia registries in the Arab world for future research. Further studies are required to outline country-specific practices, improve resource allocation, and enhance obstetric population safety and satisfaction.
产科麻醉指南对于规范全球产科麻醉实践和确保高质量的患者护理至关重要。然而，实践可能因不同的环境而异，且来自阿拉伯国家的相关数据有限。本研究旨在深入了解阿拉伯国家几家主要医院的产科麻醉实践。
向阿拉伯国家 22 个国家中的 11 个国家的 85 名产科麻醉医师/麻醉主席的主要医院发送了一份电子邮件问卷。该调查收集了关键的结构和与过程相关的产科麻醉指标数据。
在联系的 85 人中，我们收到了 56 份回复（65.8%），其中 41 份回复完整，提供了产科麻醉指标的见解。关于结构：31 家（76%）医院的手术室紧邻产房，所有医院都设有重症监护室，22 家（54%）医院有产科麻醉主任。关于设备：19 家（46%）医院的产房配备了视频喉镜，20 家（49%）医院偶尔使用超声进行硬膜外麻醉。关于过程：33 家（81%）医院定期召开会议，21 家（51%）医院进行研究。在进行硬膜外和脊髓麻醉程序之前，26 家（63%）和 28 家（68%）医院要求无出血并发症病史的患者进行凝血研究，而 38 家（93%）和 36 家（88%）医院分别要求进行血小板计数。在分娩镇痛方面，34 家（83%）医院主要使用硬膜外麻醉，15 家（37%）医院在高危妊娠中预防性放置导管。对于剖宫产，40 家（98%）医院使用脊髓麻醉，其中 16 家（39%）医院在脊髓麻醉中使用鞘内吗啡，22 家（54%）医院在全身麻醉前进行抽吸预防。关于脊髓麻醉引起的低血压，6 家（15%）医院使用预防性苯肾上腺素输注。
与国际建议相比，本调查突出了阿拉伯国家几家主要医院之间产科麻醉实践的差异。它强调了在阿拉伯世界建立产科麻醉登记处以进行未来研究的必要性。需要进一步研究以概述特定国家的实践、改善资源分配，并提高产科人群的安全性和满意度。
