Universität zu Köln

Marcus, H. E., Behrend, A., Schier, R., Dagtekin, O., Teschendorf, P., Boettiger, B. W. and Spoehr, F. (2011). Anesthesiological management of Caesarean sections. Nationwide survey in Germany. Anaesthesist, 60 (10). S. 916 - 928. NEW YORK: SPRINGER. ISSN 0003-2417

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Abstract

Background. The rate of Caesarean sections in Germany continues to rise. The change in anesthetic technique of choice from general to spinal anesthesia began later than in other countries and at the last survey in 2002 was not widely established. The literature on the anesthetic management of Caesarean sections contains many controversies, for example fluid preload before performing spinal anesthesia and the vasopressor of choice. Other issues have received relatively little attention, such as the level of experience of anesthesiologists working autonomously on the labour ward or the timing of antibiotic prophylaxis. The aim of the current survey was to provide an updated overview of anesthetic management of Caesarean sections in Germany. Material and Methods. A questionnaire was sent out to 709 departments of anesthesiology serving obstetric units in Germany. The questionnaire concerned various aspects of anesthetic management of Caesarean sections. Results. A total of 360 questionnaires (50.8%) were returned of which 346 were complete and could be analyzed, accounting for 330,000 births and 90,000 Caesarean sections per year. The predominant anesthetic method used for Caesarean sections was spinal anesthesia (90.8%) using hyperbaric bupivacaine and in approximately one third of the hospitals surveyed without administering intrathecal opioids. Approximately 12% of the departments surveyed used traumatic Quincke needles. In 86.2% the vasopressor of choice was caffedrine/theodrenaline. Nitrous oxide was used in only 19.2% of departments surveyed when general anesthesia is performed. An antibiotic drug was administered in only 11% of hospitals before cord clamping. In 43.1% no neonatologist was available to treat unexpected critically ill newborns. In 32.1% of departments surveyed residents with less than 2 years experience worked autonomously on the labour ward. Conclusions. Currently the predominant anesthetic technique of choice in Germany is spinal anaesthesia and at a much higher rate than in 2002. In addition 12% of departments use traumatic Quincke needles which are associated with a higher incidence of postpuncture headache. Nitrous oxide is no longer frequently used in Germany. Finally, the administration of an antibiotic before cord clamping has been shown to lead to lower rates of endometritis and postoperative wound infection without detrimental effects on the newborn. This is practiced in only a small minority of departments across Germany.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Marcus, H. E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Behrend, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schier, R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Dagtekin, O. UNSPECIFIED UNSPECIFIED UNSPECIFIED Teschendorf, P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Boettiger, B. W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Spoehr, F. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-487598
DOI:	10.1007/s00101-011-1931-y
Journal or Publication Title:	Anaesthesist
Volume:	60
Number:	10
Page Range:	S. 916 - 928
Date:	2011
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	0003-2417
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language POSTDURAL PUNCTURE HEADACHE; SPINAL-ANESTHESIA; NITROUS-OXIDE; DELIVERY; BUPIVACAINE; PROPHYLAXIS; PREGNANCY; NEEDLES; TRIAL Multiple languages Anesthesiology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/48759