ISSN : 2146-3123
E-ISSN : 2146-3131

Current Practice in Obstetric Anesthesia and Analgesia in Public Hospitals of Greece: a 2016 National Survey
Chryssoula Staikou1, Alexandros Μakris2, Kassiani Theodoraki1, Athanasia Τsaroucha1, Amalia Douma3, Eleni Μoka4, Eleni Αrnaoutoglou5, Tilemahos Paraskevopoulos6, Ioanna Siafaka1, Efi Stavropoulou6, Eriphili Αrgyra1
1Clinic of Anesthesia, Aretaieio Hospital, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
2Clinic of Anesthesia, Asklipieio Voulas General Hospital, Athens, Greece
3Clinic of Anesthesia, Georgios Gennimatas General Hospital, Athens, Greece
4Clinic of Anesthesia, Creta InterClinic Hospital, Heraklion, Crete, Greece
5Clinic of Anesthesia, General University Hospital of Larissa, Larissa, Greece
6Clinic of Anesthesia, General Hospital of Attica KAT, Athens, Greece
DOI : 10.4274/balkanmedj.2018.0083

Aims: The aim of this nationwide descriptive survey was to assess the use of regional anesthesia in obstetrics in Greek public hospitals.
Methods: The survey was conducted between March and August, 2016. A structured questionnaire was sent to 50 Anesthesia Departments in Greek Public Hospitals with obstetric units.
Results: The response rate was 94%. Data corresponded to 9475 cesarean and 8155 vaginal deliveries. Regional anesthesia was used in 69.2% of cesarean, with single shot spinal being the most popular technique (44.3% of all cesarean). Combined spinal-epidural anesthesia was used in 18.1% of all cesarean (35.1% in Athens versus 7.9% in periphery, p<0.001). Post-cesarean analgesia was mainly based on simple analgesics and systematic opioids (78.6%). Long acting spinal opioids were rarely used (in 4.4% of spinals and spinal/epidurals). Labor epidural analgesia was applied in 19.1% of all vaginal deliveries (30.3% in Athens versus 13.1% in periphery, p<0.001). Paracetamol and pethidine represented the standard labor analgesia in 48.9% and 55.3% of hospitals, respectively. Intravenous remifentanil was used in 10.6% of hospitals (50% of Athens’ versus 2.5% of peripheral hospitals, p=0.002). In 48.9% of hospitals, mainly in periphery, the anesthesiologists did not get involved in labor analgesia.
Conclusion: Regional anesthesia represents the most common practice for cesarean in Greek public hospitals, but still the percentage of general anesthesia remains high. Also, the use of labor epidural analgesia is quite limited, especially in periphery.

Keywords : Analgesia obstetric, anesthesia obstetric, anesthesia regional, healthcare surveys
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