Meuser T, Eichler F, Grond S, Winkler B, Lehmann K A
Klinik und Poliklinik für Anästhesiologie und Operative Intensivmedizin der Universität zu Köln.
Anaesthesist. 1998 Jul;47(7):557-64. doi: 10.1007/s001010050596.
Goal of this survey is to give an overview of anaesthesia for caesarean section in Germany.
In 1994 and 1995, we sent a questionnaire to the chief-anaesthetists of all German hospitals with departments of gynaecology/obstetrics to find out the routine anaesthetic procedures for caesarean section.
We obtained data from 409 hospitals (response rate 46.4%) with 321,816 births--50,123 of which were sections (mean caesarean section rate 16.6%). The mean general anaesthesia rate for elective caesarean sections was 66.5%, for non-elective sections 90.8%. The mean epidural anaesthesia rate for caesarean section was 22.6% and the mean spinal anaesthesia rate was 9.8%. For general anaesthesia most hospitals used antacids and/or histamine2-receptor antagonists (64.6% of responding hospitals). Anaesthesia was induced with intravenous barbiturates (82%), succinylcholine for intubation (98.2%) and no opioids before clamping of the cord (94.8%). For regional anaesthesia bupivacaine was the most common local anaesthetic (spinal 84.0%, epidural 96.8%). Opioids were added to local anaesthetics for epidural anaesthesia at 21.4% of the hospitals.
General anaesthesia is the commonest practice for caesarean sections at German hospitals. Nowadays regional anaesthesia gains more importance compared to previous German surveys and in agreement with foreign data.
本次调查的目的是概述德国剖宫产手术的麻醉情况。
1994年和1995年，我们向德国所有设有妇产科的医院的麻醉科主任发送了一份调查问卷，以了解剖宫产手术的常规麻醉程序。
我们从409家医院（回复率46.4%）获得了数据，这些医院共有321,816例分娩，其中50,123例为剖宫产（平均剖宫产率16.6%）。择期剖宫产的全身麻醉平均率为66.5%，非择期剖宫产为90.8%。剖宫产的硬膜外麻醉平均率为22.6%，蛛网膜下腔麻醉平均率为9.8%。对于全身麻醉，大多数医院使用抗酸剂和/或组胺2受体拮抗剂（64.6%的回复医院）。麻醉诱导使用静脉巴比妥类药物（82%）、琥珀酰胆碱用于插管（98.2%），脐带钳夹前不使用阿片类药物（94.8%）。对于区域麻醉，布比卡因是最常用的局部麻醉药（蛛网膜下腔麻醉为84.0%，硬膜外麻醉为96.8%）。21.4%的医院在局部麻醉药中添加了阿片类药物用于硬膜外麻醉。
全身麻醉是德国医院剖宫产手术最常用的方法。与德国以往的调查相比，如今区域麻醉的重要性有所增加，并且与国外数据一致。
