Wulf H, Stamer U
Klinik für Anaesthesiologie und Operative Intensivmedizin, Christian-Albrechts-Universität Kiel.
Anaesthesist. 1998 Jan;47(1):59-63. doi: 10.1007/s001010050524.
Obviously there is a world-wide trend towards regional anaesthesia for caesarean section (CS). Data on the current practice in Germany are lacking.
In 1996 questionnaires on obstetric anaesthesia were mailed to all University departments of anaesthesia.
All 38 University Hospitals with obstetric units replied (100%). Mean annual delivery rate was 1156 with a mean CS-rate of 24%. For scheduled CS the University departments used general anaesthesia in most cases (60%), followed by epidural (31%) and spinal anaesthesia (9%). General anaesthesia was predominantly used for more urgent (87%) or emergency deliveries (99%). Spinal anaesthesia was offered to patients as an option of anaesthesia for CS in 16 of 38 departments, epidural anaesthesia in 36 of 38. The majority of university hospitals (22 of 38) performed more than 25% of their CS in epidural anaesthesia; 14 departments had a ratio of at least 50% of regional anaesthesia. 28 of 32 centres administered some kind of acid aspiration chemoprophylaxis as a routine management. Special devices for the management of a difficult airway were provided in 61% of the hospitals within the delivery unit. In 70% the anaesthesiologist was responsible for the postoperative pain management following CS.
A significant trend towards regional anaesthesia for CS has taken place in German university hospitals: According to a former survey regional anaesthesia was used in less than 10% of CS in 1977, whereas in the current evaluation from 1996 this figure was significantly higher (40%). Nevertheless, compared to other countries the rate of general anaesthesia still is rather high.
显然，剖宫产（CS）采用区域麻醉在全球呈一种趋势。德国目前这方面的实践数据尚缺。
1996年，向所有大学麻醉科邮寄了关于产科麻醉的调查问卷。
所有38家设有产科的大学医院均给予回复（回复率100%）。年平均分娩率为1156例，剖宫产平均率为24%。对于择期剖宫产，大学科室大多采用全身麻醉（60%），其次是硬膜外麻醉（31%）和脊髓麻醉（9%）。全身麻醉主要用于更紧急的情况（87%）或急诊分娩（99%）。38个科室中有16个为患者提供脊髓麻醉作为剖宫产麻醉的一种选择，38个中有36个提供硬膜外麻醉。大多数大学医院（38个中的22个）超过25%的剖宫产采用硬膜外麻醉；14个科室区域麻醉的比例至少为50%。32个中心中有28个将某种酸误吸化学预防作为常规处理措施。产房内61%的医院配备了处理困难气道的特殊设备。70%的情况下麻醉医生负责剖宫产术后疼痛管理。
德国大学医院剖宫产采用区域麻醉有显著趋势：根据之前的一项调查，1977年区域麻醉在剖宫产中的使用率不到10%，而在1996年的当前评估中这一数字显著更高（40%）。然而，与其他国家相比，全身麻醉率仍然相当高。
