Baaj Jumana, Alhaizan Maysoon, Alsafar Reem, Muammar Abdullah Bin, Aldaijy Mansor, Alfaifi Rakan
Department of Anaesthesia, College of Medicine and King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
Department of Obstetrics and Gynecology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Saudi J Anaesth. 2025 Jul-Sep;19(3):277-285. doi: 10.4103/sja.sja_557_24. Epub 2025 Jun 16.
Local anesthetics (LAs) are commonly used in obstetrics and gynecology (OB-GYN); however, inappropriate administration can cause local anesthetic systemic toxicity (LAST), a life-threatening condition. For safe medical practice, healthcare providers should carefully follow the guidelines for administering LAs for early identification and proper management of LAST when it occurs.
This nationwide study used a 36-item self-administered questionnaire administered to healthcare professionals in OB-GYN and anesthesiology. The survey assessed the knowledge, attitudes, and practices of commonly used LA agents, their appropriate dosage, and awareness of LAST's management.
A study of 391 Saudi healthcare professionals, between OB-GYN (51.2%) and anesthesiology (48.8%), reported greater engagement in anesthetic training and usage among anesthesiologists (88% trained, 58.1% daily use) than among OB-GYNs (38.5% trained, 30.5% daily use). OB-GYNs most commonly performed perineal tear repairs (88.5%), whereas anesthesiologists mainly performed paracervical blocks (89.5%). Lidocaine was the preferred local anesthetic for OB-GYNs at 93.5%, with anesthesiologists also favoring lidocaine but showing a higher use of bupivacaine (75.4%). Furthermore, the knowledge, attitudes, and practices scores of OB-GYN participants were significantly lower scores in all parameters compared to the anesthesiology participants ( < 0.001).
Healthcare professionals in OB-GYN lack adequate knowledge of the safe and effective use of LA agents. Their knowledge must be increased through education to ensure safe practices.
局部麻醉剂（LAs）常用于妇产科（OB - GYN）；然而，不当使用可能导致局部麻醉剂全身毒性（LAST），这是一种危及生命的情况。为了安全行医，医疗保健提供者应严格遵循局部麻醉剂的给药指南，以便在LAST发生时能早期识别并妥善处理。
这项全国性研究采用了一份36项的自填式问卷，对妇产科和麻醉科的医疗专业人员进行调查。该调查评估了常用局部麻醉剂的知识、态度和实践、其适当剂量以及对LAST处理的认识。
对391名沙特医疗专业人员的研究发现，妇产科（51.2%）和麻醉科（48.8%）中，麻醉科医生参与麻醉培训和使用的比例更高（88%接受过培训，58.1%每天使用），而妇产科医生的比例分别为38.5%接受过培训，30.5%每天使用。妇产科医生最常进行会阴撕裂修补（88.5%），而麻醉科医生主要进行宫颈旁阻滞（89.5%）。利多卡因是妇产科医生首选的局部麻醉剂，占93.5%，麻醉科医生也倾向于使用利多卡因，但布比卡因的使用比例更高（75.4%）。此外，与麻醉科参与者相比，妇产科参与者在所有参数上的知识、态度和实践得分均显著较低（<0.001）。
妇产科医疗专业人员缺乏关于安全有效使用局部麻醉剂的足够知识。必须通过教育提高他们的知识水平，以确保安全操作。
