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

Abstract

Aims: This descriptive survey was to evaluate 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 corresponding to 9475 cesarean and 8155 vaginal deliveries were collected. Regional anesthesia was used in 69.2% of all cesareans, with single shot spinal being the most popular (44.3% of all cesareans). Combined spinal-epidural anesthesia was used in 18.1% of all cesareans (35.1% in hospitals of Athens versus 7.9% outside Athens, p<0.001). Post-cesarean analgesia was applied with simple analgesics and systematic opioids (78.6%). Long-acting spinal opioids were rarely used (4.4% of spinal and spinal/epidurals). Labor epidural analgesia was applied in 19.1% of all vaginal deliveries (30.3% in Athens versus 13.1% outside Athens, p<0.001). Paracetamol and pethidine represented the standard labor analgesics in 48.9% and 55.3% of all hospitals. Intravenous remifentanil was used in 10.6% of hospitals (50% in Athens versus 2.5% outside Athens, p=0.002). In 48.9% of hospitals, mainly outside Athens, the anesthesiologists did not get involved in labor analgesia.
Conclusion: Regional anesthesia is the most common practice for cesareans in Greek public hospitals; however, the percentage of general anesthesia remains high. In addition, the use of labor epidural analgesia is limited in hospitals outside Athens.

Keywords : Analgesia, healthcare, obstetrical, regional anesthesia, survey
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